头孢曲松联合甲强龙冲击疗法治疗放射性肺部感染患者的疗效
|
摘要
目的研究头孢曲松联合甲强龙冲击疗法治疗放疗致放射性肺部感染患者的临床疗效。方法选取2015年6月-2017年6月于医院接受诊治的放射性肺部感染患者98例为研究对象,随机分为对照组和研究组,各49例。两组患者接受常规的抗感染、吸氧治疗,同时对照组行甲强龙冲击疗法治疗,研究组患者开展头孢曲松联合甲强龙冲击疗法治疗。比较两组患者临床症状缓解时间、功能状态卡氏评分(KPS)及炎症因子[肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)]水平。结果研究组患者肺部啰音消失时间、咳嗽消失时间、呼吸困难消失时间分别为(4.95±2.54)天、(4.04±2.46)天、(4.87±2.35)天均短于对照组(P<0.05);治疗后,两组患者健康状况KPS功能评分均高于治疗前,且研究组(82.51±5.63)分高于对照组(P<0.001);治疗后,两组患者血清TNF-α、TGF-β1水平均低于治疗前,且研究组分别为(10.54±1.63)ng/L、(8.16±1.37)g/L低于对照组(P<0.001)。结论头孢曲松联合甲强龙冲击疗法治疗放疗致放射性肺部感染疗效较好,能有效缓解临床症状,减轻炎症反应,改善机体功能状态,具有一定的临床价值。
OBJECTIVE To study the clinical efficacy of ceftriaxone in combination with methylprednisolone in the treatment of radiation-induced pulmonary infections.METHODS 98 cases of patients with radioactive lung infection who were treated in our hospital from Jun.2015 to Jun.2017 were selected as the research subjects.All the patients were divided into the control group and the study group according to random number table method,with 49 cases in each group.Both groups of patients received conventional anti-infection and oxygen therapy,the patients in the control group were given methylprednisolone therapy for treatment,and the patients in the study group were given ceftriaxone combined with methylprednisolone therapy.The clinical symptoms remission time,Karnofsky score(KPS)and levels of inflammatory factors(TNF-alpha,transforming growth factor-beta 1)were compared between the two groups.RESULTS The time of lung rale disappearance,cough disappearance and dyspnea disappearance in the study group were(4.95±2.54)days,(4.04±2.46)days,(4.87±2.35)days,respectively,significantly lower than those in the control group(P<0.05).After treatment,the KPS function scores of both groups were significantly higher than those before treatment,and the score of the study group(82.51±5.63)was significantly higher than that of the control group(P<0.001).After treatment,the levels of TNF-a and TGF-beta-1 in both groups were significantly lower than those before treatment,and the levels of TNF-αand TGF-β1 in the study group were(10.54±1.63)ng/L and(8.16±1.37)g/L,respectively,significantly lower than those in the control group(P<0.001).CONCLUSIONCeftriaxone combined with methylprednisolone therapy has a significant clinical effect in the treatment of radiation-induced lung infection,which can effectively alleviate the clinical symptoms,reduce inflammation and improve the body's functional status,and is worthy of clinical promotion.
OBJECTIVE To study the clinical efficacy of ceftriaxone in combination with methylprednisolone in the treatment of radiation-induced pulmonary infections.METHODS 98 cases of patients with radioactive lung infection who were treated in our hospital from Jun.2015 to Jun.2017 were selected as the research subjects.All the patients were divided into the control group and the study group according to random number table method,with 49 cases in each group.Both groups of patients received conventional anti-infection and oxygen therapy,the patients in the control group were given methylprednisolone therapy for treatment,and the patients in the study group were given ceftriaxone combined with methylprednisolone therapy.The clinical symptoms remission time,Karnofsky score(KPS)and levels of inflammatory factors(TNF-alpha,transforming growth factor-beta 1)were compared between the two groups.RESULTS The time of lung rale disappearance,cough disappearance and dyspnea disappearance in the study group were(4.95±2.54)days,(4.04±2.46)days,(4.87±2.35)days,respectively,significantly lower than those in the control group(P<0.05).After treatment,the KPS function scores of both groups were significantly higher than those before treatment,and the score of the study group(82.51±5.63)was significantly higher than that of the control group(P<0.001).After treatment,the levels of TNF-a and TGF-beta-1 in both groups were significantly lower than those before treatment,and the levels of TNF-αand TGF-β1 in the study group were(10.54±1.63)ng/L and(8.16±1.37)g/L,respectively,significantly lower than those in the control group(P<0.001).CONCLUSIONCeftriaxone combined with methylprednisolone therapy has a significant clinical effect in the treatment of radiation-induced lung infection,which can effectively alleviate the clinical symptoms,reduce inflammation and improve the body's functional status,and is worthy of clinical promotion.
引文
[1]李学章,刘莹.胸部肿瘤放射性肺损伤患者肺部感染的临床诊治[J].中华医院感染学杂志,2015,25(19):4447-4449.
[2] Bledsoe TJ,Nath SK,Decker RH.Radiation pneumonitis[J].Clin Chest Med,2017,38(2):201-208.
[3] Seo YH,Kim JS,Seo SC,et al.Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia[J].Korean J Pediatr,2014,57(4):186-192.
[4]樊友武.放疗所致肺部病变的影像学诊断[J].放射学实践,1995,10(4):168-170.
[5]刘惠明,王奇峰,万欣,等.252Cf中子近距离放疗加外照射治疗食管鳞癌708例临床分析[J].中华肿瘤防治杂志,2017,24(13):916-920.
[6] Emam H,Refaat A,Jawaid P,et al.Hyperthermia and radiation reduce the toxic side-effects of bufadienolides for cancer therapy.[J].Oncol Lett,2017,14(1):1035-1040.
[7]彭伟陈津魏伟,等.血清KL-6预测肺癌患者放疗后发生放射性肺炎风险的研究[J].中华放射医学与防护杂志,2017,37(12):891-895.
[8] Kawai S,Yokota T,Onozawa Y,et al.Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bioradiotherapy for locally advanced head and neck cancer:a monocentric case control study[J].BMC Cancer,2017,17(1):59.
[9]赵聪,刘兰平,汤良,等.双肺电子密度值和放化疗模式与NSCLC放射性肺炎发生相关性[J].中华肿瘤防治杂志,2017,24(18):1305-1309.
[10] Arthur LE,Kizor RS,Selim AG,et al.Antibiotics for ventilator-associated pneumonia.[J].Cochrane Database Syst Rev,2016,10(10):CD004267.
[11]柳立岩,王春,张雪云.血清降钙素原、C-反应蛋白及纤维蛋白原检测在脑卒中相关性肺炎中的临床意义[J].贵州医科大学学报,2016,41(7):826-828.
[12]杨勇琼.头孢曲松与头孢克肟序贯疗法对急性呼吸道感染患儿临床症状及炎性因子的影响[J].检验医学与临床,2015,12(13):1917-1918.
[13] Yong SC,Chen SJ,Boo NY.Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants:a randomised control study[J].Arch Dis Child Fetal Neonatal Ed,2005,90(6):F480-483.
[14] Gianecini R,Oviedo C,Stafforini G,et al.Neisseria gonorrhoeae resistant to ceftriaxone and cefixime,Argentina[J].Emerg Infect Dis,2016,22(6):1139-1141.
[2] Bledsoe TJ,Nath SK,Decker RH.Radiation pneumonitis[J].Clin Chest Med,2017,38(2):201-208.
[3] Seo YH,Kim JS,Seo SC,et al.Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia[J].Korean J Pediatr,2014,57(4):186-192.
[4]樊友武.放疗所致肺部病变的影像学诊断[J].放射学实践,1995,10(4):168-170.
[5]刘惠明,王奇峰,万欣,等.252Cf中子近距离放疗加外照射治疗食管鳞癌708例临床分析[J].中华肿瘤防治杂志,2017,24(13):916-920.
[6] Emam H,Refaat A,Jawaid P,et al.Hyperthermia and radiation reduce the toxic side-effects of bufadienolides for cancer therapy.[J].Oncol Lett,2017,14(1):1035-1040.
[7]彭伟陈津魏伟,等.血清KL-6预测肺癌患者放疗后发生放射性肺炎风险的研究[J].中华放射医学与防护杂志,2017,37(12):891-895.
[8] Kawai S,Yokota T,Onozawa Y,et al.Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bioradiotherapy for locally advanced head and neck cancer:a monocentric case control study[J].BMC Cancer,2017,17(1):59.
[9]赵聪,刘兰平,汤良,等.双肺电子密度值和放化疗模式与NSCLC放射性肺炎发生相关性[J].中华肿瘤防治杂志,2017,24(18):1305-1309.
[10] Arthur LE,Kizor RS,Selim AG,et al.Antibiotics for ventilator-associated pneumonia.[J].Cochrane Database Syst Rev,2016,10(10):CD004267.
[11]柳立岩,王春,张雪云.血清降钙素原、C-反应蛋白及纤维蛋白原检测在脑卒中相关性肺炎中的临床意义[J].贵州医科大学学报,2016,41(7):826-828.
[12]杨勇琼.头孢曲松与头孢克肟序贯疗法对急性呼吸道感染患儿临床症状及炎性因子的影响[J].检验医学与临床,2015,12(13):1917-1918.
[13] Yong SC,Chen SJ,Boo NY.Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants:a randomised control study[J].Arch Dis Child Fetal Neonatal Ed,2005,90(6):F480-483.
[14] Gianecini R,Oviedo C,Stafforini G,et al.Neisseria gonorrhoeae resistant to ceftriaxone and cefixime,Argentina[J].Emerg Infect Dis,2016,22(6):1139-1141.