头孢他啶联合氨溴索治疗老年2型糖尿病并肺部感染疗效及对血清T淋巴细胞亚群的影响
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摘要
目的探讨头孢他啶联合氨溴索治疗老年2型糖尿病(type 2 diabetes mellitus,T2DM)并肺部感染疗效及对血清T淋巴细胞亚群的影响。方法通过对资阳市第一人民医院2016年11月—2017年11月就诊治疗的120例老年T2DM并肺部感染患者临床资料做回顾性分析。根据治疗方式的不同分为观察组、对照组,各60例,对照组给予头孢噻肟钠联合氨溴索治疗,观察组给予头孢他啶联合氨溴索治疗。比较2组患者治疗疗效、不良反应发生情况及治疗前后的白细胞计数(WBC)、C-反应蛋白(C-reactive protein,CRP)、血清T淋巴细胞亚群水平。结果观察组的治疗总有效率高于对照组(χ~2=4.675,P=0.031);治疗后2组患者WBC、CR P水平均较治疗前降低(P<0.05),且观察组WBC、CR P水平较对照组下降明显;治疗后对照组CD3~+、CD8~+、CD4~+/CD8~+水平与治疗前比较差异无统计学意义(P>0.05),观察组CD3~+、CD4~+/CD8~+水平较治疗前上升,CD8~+水平较治疗前下降(P<0.05),观察组治疗后CD3~+、CD4~+/CD8~+水平较对照组上升,CD8~+水平较对照组下降(P<0.05);2组患者不良反应总发生率比较差异无统计学意义(χ~2=0.120,P=0.729)。结论头孢他啶联合氨溴索治疗老年T2DM并肺部感染患者临床疗效显著,可有效的抑制炎性因子表达,调节血清T淋巴细胞亚群水平,且安全可靠。
Objective To investigate the therapeutic effect of ceftazidime combined with ambroxol in the treatment of elderly type 2 diabetes complicated with pulmonary infections and its effect on serum T lymphocyte subsets. Methods The clinical data of 120 elderly patients with T2DM and pulmonary infections treated in our hospital between November 2016 and November 2017 was analyzed retrospectively. These patients were divided into the observation group(60 cases) and control group(60 cases) according to the treatment methods. The control group was given cefotaxime sodium combined with ambroxol, while the observation group was given ceftazidime combined with ambroxol. The efficacy, rate of adverse reactions and levels of WBC, CRP and serum T lymphocyte subsets before and after treatment were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that of the control group(X~2=4.675, P=0.031). After treatment, the levels of WBC and CRP in the two groups were lower(P<0.05), especially in the observation group. After treatment, the levels of CD8~+, CD4~+/CD8~+ and CD3~+ in the control group hardly changed(P>0.05). The levels of CD4~+/CD8~+ and CD34~+ in the observation group increased after treatment, while the CD8~+ level decreased(P<0.05), The levels of CD4/CD8~+ and CD3~+ in the observation group were higher than those in the control group, while the levels of CD8~+were lower(P<0.05). The total incidence of adverse reactions in the two groups was not significantly different(X~2=0.120, P=0.729). Conclusion Ceftazidime combined with ambroxol is effective in the treatment of elderly patients with T2DM and pulmonary infections. It can effectively inhibit the expression of inflammatory factors and regulate the level of T lymphocyte subsets in serum, and it is safe and reliable.
Objective To investigate the therapeutic effect of ceftazidime combined with ambroxol in the treatment of elderly type 2 diabetes complicated with pulmonary infections and its effect on serum T lymphocyte subsets. Methods The clinical data of 120 elderly patients with T2DM and pulmonary infections treated in our hospital between November 2016 and November 2017 was analyzed retrospectively. These patients were divided into the observation group(60 cases) and control group(60 cases) according to the treatment methods. The control group was given cefotaxime sodium combined with ambroxol, while the observation group was given ceftazidime combined with ambroxol. The efficacy, rate of adverse reactions and levels of WBC, CRP and serum T lymphocyte subsets before and after treatment were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that of the control group(X~2=4.675, P=0.031). After treatment, the levels of WBC and CRP in the two groups were lower(P<0.05), especially in the observation group. After treatment, the levels of CD8~+, CD4~+/CD8~+ and CD3~+ in the control group hardly changed(P>0.05). The levels of CD4~+/CD8~+ and CD34~+ in the observation group increased after treatment, while the CD8~+ level decreased(P<0.05), The levels of CD4/CD8~+ and CD3~+ in the observation group were higher than those in the control group, while the levels of CD8~+were lower(P<0.05). The total incidence of adverse reactions in the two groups was not significantly different(X~2=0.120, P=0.729). Conclusion Ceftazidime combined with ambroxol is effective in the treatment of elderly patients with T2DM and pulmonary infections. It can effectively inhibit the expression of inflammatory factors and regulate the level of T lymphocyte subsets in serum, and it is safe and reliable.
引文
[1]史荣,冯飞,陈袁,等.不同抗菌治疗对老年糖尿病合并肺部感染患者血清学指标及疗效的影响研究[J].中华医院感染学杂志,2017,27(20):4 645-4 648.
[2]戴斌.胸腺法新对老年SCA P患者血清免疫蛋白及T淋巴细胞亚群的影响及疗效分析[J].海南医学院学报,2015,21(3):353-355.
[3]王波,龙敏,程伟,等.哌拉西林/舒巴坦联合盐酸氨溴索治疗2型糖尿病肺部感染患者的疗效分析[J].中华医院感染学杂志,2015,26(10):2 222-2 224.
[4]刘伟明,张天镇,王刚.头孢他啶联合左氧氟沙星治疗心力衰竭患者肺部感染的疗效及其对IL-6、TNF-α和BNP水平的影响[J].临床和实验医学杂志,2016,15(4):364-367.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志,2012,20(1):54-109.
[6]高育瑶,张爱莉.全国肺部感染学术会议纪要[J].实用内科杂志,1990,13(10):368-371.
[7]薛晓艳,高占成,朱继红,等.中国社区获得性肺炎诊断和治疗指南的评价[J].北京大学学报(医学版),2006,38(3):276-279.
[8]Yao L,Wu YT,Wang XB,et al.Curative effect of insulin pump in elderly pat ient s with type 2 diabetes mellitus complicating pulmonar y infection[J].Chinese Jour nal of Evidence-Based Cardiovascular Medicine,2016,23(8):225-227.
[9]郭文霞.老年2型糖尿病肺结核患者合并医院获得性肺炎的危险因素研究[J].实用心脑肺血管病杂志,2015,22(5):43-46.
[10]谭志雄,陈山,陈亚想.维生素D与2型糖尿病合并肺部感染相关性[J].临床肺科杂志,2016,21(3):447-449.
[11]林凤平,李进杰,王丽,等.2型糖尿病肺部感染患者持续皮下胰岛素注射的应用效果分析[J].中华医院感染学杂志,2016,26(2):335-337.
[12]杨玉华,曹秀萍,吴庆勇,等.糖尿病并发获得性肺部感染患者病原菌分布及药物敏感性研究[J].中华医院感染学杂志,2017,27(18):4 143-4 146.
[13]桂婵,孙惠君,马琳.注射用头孢他啶联合盐酸氨溴索注射液致不良反应1例[J].中南药学,2017,14(7):1 020.
[14]胡全福,欧阳绍基,姚榕威,等.曲安奈德联合盐酸氨溴索治疗分泌性中耳炎患者的临床疗效及对机体炎性因子、细胞免疫指标的影响[J].海南医学院学报,2016,22(23):2 897-2 9 0 0.
[15]刘博,张睿,彭伟,等.盐酸氨溴索辅助治疗对慢性阻塞性肺疾病伴肺部感染患者肺功能和血气指标的影响[J].疑难病杂志,2016,15(10):1 020-1 023.
[16]孔令武,苏亚红.氨溴索注射液联合噻托溴铵治疗慢性阻塞性肺疾病合并肺结核的临床疗效及其对血清白介素6、干扰素γ、肿瘤坏死因子α水平的影响研究[J].实用心脑肺血管病杂志,2015,22(10):135-137.
[17]胡波.盐酸氨溴索联合布地奈德治疗小儿支气管肺炎的临床疗效及其对C反应蛋白和白细胞计数的影响[J].实用心脑肺血管病杂志,2015,22(8):68-70.
[18]Chen L,Zheng L,Li W U,et al.Risk factors and distribution of pathogens in elderly patients with type 2 diabetes mellitus complicated with pulmonary infection[J].Modern Preventive Medicine,2017,44(13):2 481-2 484.
[19]杨丽丽,顾东明,俞杰,等.盐酸氨溴索联合孟鲁司特钠对小儿哮喘血清MMP-9和TIMP-1的影响[J].现代生物医学进展,2016,16(34):6 706-6 709.
[20]韩红燕.注射用头孢他啶联合阿奇霉素对老年铜绿假单胞菌呼吸道感染的疗效观察[J].中国医师进修杂志,2014,37(22):69-70.
[2]戴斌.胸腺法新对老年SCA P患者血清免疫蛋白及T淋巴细胞亚群的影响及疗效分析[J].海南医学院学报,2015,21(3):353-355.
[3]王波,龙敏,程伟,等.哌拉西林/舒巴坦联合盐酸氨溴索治疗2型糖尿病肺部感染患者的疗效分析[J].中华医院感染学杂志,2015,26(10):2 222-2 224.
[4]刘伟明,张天镇,王刚.头孢他啶联合左氧氟沙星治疗心力衰竭患者肺部感染的疗效及其对IL-6、TNF-α和BNP水平的影响[J].临床和实验医学杂志,2016,15(4):364-367.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志,2012,20(1):54-109.
[6]高育瑶,张爱莉.全国肺部感染学术会议纪要[J].实用内科杂志,1990,13(10):368-371.
[7]薛晓艳,高占成,朱继红,等.中国社区获得性肺炎诊断和治疗指南的评价[J].北京大学学报(医学版),2006,38(3):276-279.
[8]Yao L,Wu YT,Wang XB,et al.Curative effect of insulin pump in elderly pat ient s with type 2 diabetes mellitus complicating pulmonar y infection[J].Chinese Jour nal of Evidence-Based Cardiovascular Medicine,2016,23(8):225-227.
[9]郭文霞.老年2型糖尿病肺结核患者合并医院获得性肺炎的危险因素研究[J].实用心脑肺血管病杂志,2015,22(5):43-46.
[10]谭志雄,陈山,陈亚想.维生素D与2型糖尿病合并肺部感染相关性[J].临床肺科杂志,2016,21(3):447-449.
[11]林凤平,李进杰,王丽,等.2型糖尿病肺部感染患者持续皮下胰岛素注射的应用效果分析[J].中华医院感染学杂志,2016,26(2):335-337.
[12]杨玉华,曹秀萍,吴庆勇,等.糖尿病并发获得性肺部感染患者病原菌分布及药物敏感性研究[J].中华医院感染学杂志,2017,27(18):4 143-4 146.
[13]桂婵,孙惠君,马琳.注射用头孢他啶联合盐酸氨溴索注射液致不良反应1例[J].中南药学,2017,14(7):1 020.
[14]胡全福,欧阳绍基,姚榕威,等.曲安奈德联合盐酸氨溴索治疗分泌性中耳炎患者的临床疗效及对机体炎性因子、细胞免疫指标的影响[J].海南医学院学报,2016,22(23):2 897-2 9 0 0.
[15]刘博,张睿,彭伟,等.盐酸氨溴索辅助治疗对慢性阻塞性肺疾病伴肺部感染患者肺功能和血气指标的影响[J].疑难病杂志,2016,15(10):1 020-1 023.
[16]孔令武,苏亚红.氨溴索注射液联合噻托溴铵治疗慢性阻塞性肺疾病合并肺结核的临床疗效及其对血清白介素6、干扰素γ、肿瘤坏死因子α水平的影响研究[J].实用心脑肺血管病杂志,2015,22(10):135-137.
[17]胡波.盐酸氨溴索联合布地奈德治疗小儿支气管肺炎的临床疗效及其对C反应蛋白和白细胞计数的影响[J].实用心脑肺血管病杂志,2015,22(8):68-70.
[18]Chen L,Zheng L,Li W U,et al.Risk factors and distribution of pathogens in elderly patients with type 2 diabetes mellitus complicated with pulmonary infection[J].Modern Preventive Medicine,2017,44(13):2 481-2 484.
[19]杨丽丽,顾东明,俞杰,等.盐酸氨溴索联合孟鲁司特钠对小儿哮喘血清MMP-9和TIMP-1的影响[J].现代生物医学进展,2016,16(34):6 706-6 709.
[20]韩红燕.注射用头孢他啶联合阿奇霉素对老年铜绿假单胞菌呼吸道感染的疗效观察[J].中国医师进修杂志,2014,37(22):69-70.