李　娥，吕佳杰



莫西沙星与头孢哌酮钠舒巴坦钠治疗老年重症肺炎的联合疗效

李娥，吕佳杰

目的探讨莫西沙星联合头孢哌酮钠舒巴坦钠治疗老年重症肺炎的疗效。方法选择80例老年重症肺炎患者，随机分为两组，对照组每12 h静脉滴注头孢哌酮钠舒巴坦钠3.0 g；观察组在此基础上，每天再静脉滴注莫西沙星0.4 g，疗程为7～14d。结果观察组总有效率为87.5%，对照组为67.5%，两组总有效率存在显著性差异(P＜0.05)。观察组在症状体征好转时间、体温恢复正常时间、痰液颜色改变时间、白细胞计数下降时间等方面均显著短于对照组（P＜0.05）。治疗后观察组细菌清除率为78.6%，显著高于对照组的52.0%(P＜0.05)。结论与单用头孢哌酮钠舒巴坦钠相比，莫西沙星联合头孢哌酮钠舒巴坦钠治疗老年重症肺炎具有高效、快速的优势，且没有明显增加不良反应的风险。

莫西沙星；头孢哌酮钠舒巴坦钠；老年；重症肺炎；疗效

[Abstract]Objective To discuss the curative effects ofmoxifloxacin and cefoperazone/sulbactam sodium on elderly patients with severe pneumonia.Methods 80 elderly patients with severe pneumonia were selected and random ly divided into two groups. Control group received intravenous drip with 3.0 g cefoperazone/sulbactam sodium every 12 h.Based on the treatment above, observation group additionally received the intravenous drip with 0.4 gmoxifloxacin.The course of treatmentwas 7-14 days.Results The total effective rate of the observation group was 87.5%,and that the control group was 67.5%.There was significant difference between the two groups(P＜0.05).The improvement time of signs and symptoms,the recovery time of body temperature,the time of sputum color changes,and the time of leucopenia in the observation group were significantly shorter than those in the control group (P＜0.05).A fter the treatment,the clearance rate of bacteria in the observation group was 78.6%which was significantly higher than that in the control group(52.0%)(P＜0.05).Conclusion Compared with the single use of cefoperazone/sulbactam sodium,the combination ofmoxifloxacin and cefoperazone/sulbactam sodium has the advantages of effectiveness and quickness and has no obvious risk in the increase of adverse reactions.

[Keywords]moxifloxacin;cefoperazone/sulbactam sodium;elderly;severe pneumonia;curative effect

重症肺炎是老年患者常见的严重呼吸系统感染性疾病，具有起病急、进展迅速、病死率高等特点。Niederman等[1]研究发现，10%以上的美国老年重症肺炎患者在入院治疗1个月内死亡。流行病学调查也显示，社区获得性重症肺炎病死率为5%左右，医院获得性重症肺炎病死率为20%～50%[2-3]。及时有效的抗生素治疗对重症肺炎的预后至关重要，常用的治疗方案为一种氟喹诺酮类抗生素或头孢菌素类抗生素与一种大环内酯类抗生素的组合[4]。但老年患者机体功能减退，既往广泛应用广谱抗生素治疗导致对抗生素耐药率升高等原因，造成老年重症肺炎的抗感染治疗效果仍不够理想。……