孙明楠 李明今 王海涛 于秀香 高芹

[摘要] 目的 探讨左氧氟沙星序贯疗法应用于老年2型糖尿病并社区获得性肺炎患者中的效果。方法 选择2018年6月—2019年6月该院收治的老年2型糖尿病并社区获得性肺炎患者202例，以随机数表法将其分为对照组与研究组，各101例。在常规对症治疗的基础上，研究组应用左氧氟沙星序贯疗法，对照组应用阿奇霉素序贯治疗。观察两组患者临床疗效、治疗前后血糖指标变化、不良反应情况。结果 研究组治疗的总有效率96.04%，高于对照组87.13%，差异有统计学意义（P<0.05）。两组治疗前与治疗后空腹血糖、餐后2 h血糖指标对比差异无统计学意义（P>0.05）。两组不良反应发生率对比差异无统计学意义（P>0.05）。结论 左氧氟沙星序贯疗法在老年2型糖尿病并社区获得性肺炎患者中具有显著的应用效果，值得临床推广。

[关键词] 左氧氟沙星序贯疗法;老年;2型糖尿病;社区获得性肺炎

[中图分类号] R587          [文献标识码] A          [文章编号] 1672-4062（2020）08（b）-0193-03

[Abstract] Objective To explore the effect of levofloxacin sequential therapy in elderly patients with type 2 diabetes mellitus and community-acquired pneumonia. Methods From June 2018 to June 2019， 202 elderly patients with type 2 diabetes mellitus and community-acquired pneumonia were selected and divided into control group and study group （101 cases）. On the basis of routine symptomatic treatment， levofloxacin sequential therapy was used in the study group and Azithromycin Sequential therapy was used in the control group. Observe the clinical efficacy， changes in blood glucose indexes before and after treatment， and adverse reactions in both groups. Results The total effective rate was 96.04% in the study group and 87.13% in the control group， the difference was statistically significant （P<0.05）. There was no statistically significant difference in fasting blood glucose and 2 hours postprandial blood glucose between the two groups before and after treatment ， the difference was not statistically significant（P>0.05）. There was no significant difference in the incidence of adverse reactions between the two groups， the difference was not statistically significant（P>0.05）. Conclusion Levofloxacin sequential therapy in elderly patients with type 2 diabetes mellitus and community-acquired pneumonia has a significant effect， it is worth clinical promotion.

[Key words] Levofloxacin sequential therapy; Elderly; Type 2 diabetes; Community acquired pneumonia

社區获得性肺炎是指院外由衣原体、病毒、细菌与支原体等多种微生物所致的肺炎，临床表现为咳嗽、咳痰、胸痛以及上呼吸道感染或鼻炎样症状[1]。老年糖尿病患者因机体抵抗力较弱，所以是社区获得性肺炎的高发群体。研究发现[2]，引发老年糖尿病并社区获得性肺炎的病原体较多，常见的病原体包括肺炎链球菌、流感嗜血杆菌等。近年来，随着抗菌药物在临床中的广泛应用，细菌耐药性不断提升，病原体也随之变迁，支原体、衣原体、嗜肺军团菌等感染情况屡见不鲜，治疗起来十分棘手[3]。序贯疗法是现阶段治疗感染性疾病的主要方案，不仅可以抑制细菌生长，同时也能够保证治疗方案的可持续性。20……