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Effect of Meropenem de-escalation therapy in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with pneumonia |
ZHANG Weiwei YANG Yan WU Keren WU Xiaoxiang |
Department of Respiratory Medicine, the 904th Hospital of the Joint Logistics Support Force of Chinese People’s Liberation Army, Jiangsu Province, Wuxi 215000, China
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Abstract Objective To explore the effect of Meropenem de-escalation therapy (DET) in the treatment of elderly patients with chronic obstructive pulmonary disease (COPD) complicated with pneumonia. Methods A total of 82 elderly patients with COPD complicated with pneumonia admitted to the 904th Hospital of the Joint Logistics Support Force of Chinese People’s Liberation Army from June 2018 to June 2021 were selected and divided into two groups by random number table method, with 41 cases in each group. The control group was given routine antibiotics, and the observation group was given Meropenem DET. The treatment time of both groups was eight days. The curative effect and the disappearance time of dyspnea, pulmonary moist rales, cough were compared between the two groups. Sputum of the two groups after treatment was collected for bacterial culture, and the bacterial clearance rate was calculated. The level of inflammation before and after treatment in the two groups was detected and the safety of the treatment scheme were observed. Results The clinical efficacy of the observation group was better than that of the control group, and the disappearance time of dyspnea, pulmonary moist rales, cough was shorter than those of the control group (P<0.05). There were no significant differences in bacterial clearance rate and total incidence of adverse reactions between the two groups (P>0.05). After treatment, the levels of C-reactive protein and procalcitonin in two groups were lower than those before treatment, and observation group was lower than control group (P<0.05). Conclusion Meropenem DET can effectively improve the therapeutic effect of elderly patients with COPD complicated with pneumonia, improve the serum inflammation level and clinical symptoms of patients, and is safe and reliable.
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[1] 白燕,辜依海,刘玥彤,等.COPD合并肺炎患者产超广谱β-内酰胺酶肺炎克雷伯菌基因型分析[J].临床误诊误治,2022,35(2):68-72.
[2] 周桃花,李国明.麻杏消痰饮治疗慢性阻塞性肺疾病的临床观察[J].中国民间疗法,2022,30(1):78-80.
[3] 陈晨,夏茵,沈知彼.补脾益气推拿手法配合定向透药治疗慢性阻塞性肺疾病稳定期临床观察[J].山西医药杂志,2021,50(9):1407-1411.
[4] 廖泳.美罗培南与舒普深降阶梯治疗社区获得性重症肺炎的疗效分析[J].医学理论与实践,2021,34(18):3170- 3172.
[5] 孙婧婧,郭利涛,马红叶,等.抗菌药物的降阶梯策略治疗呼吸机相关性肺炎的Meta分析[J].中国医药导报,2019, 16(35):107-111,115.
[6] 谢甜,王敏,吴海洪.持续静脉输注美罗培南治疗重症类鼻疽肺炎的效果[J].中国医药导报,2020,17(10):157- 160.
[7] 陈辅萍.美罗培南联合莫西沙星治疗慢性阻塞性肺疾病合并感染性肺炎的观察[J].山西医药杂志,2020,49(7):850-852.
[8] 许红飞,刘艳春,王春鲜.两种呼吸喹诺酮类抗菌药序贯给药治疗老年重症慢性阻塞性肺疾病急性加重的对比研究[J].实用老年医学,2021,35(3):270-273.
[9] 陈金钟.血必净注射液联合美罗培南治疗老年重症肺炎病人的疗效研究[J].实用老年医学,2019,33(2):182- 185.
[10] 慢性阻塞性肺疾病诊治专家组.祛痰/抗氧化药治疗慢性阻塞性肺疾病中国专家共识[J].国际呼吸杂志,2015, 35(16):1201-1209.
[11] 何新华.社区获得性肺炎的诊治——2014指南[C]//中华医学会急诊医学分会.中华医学会急诊医学分会第17次全国急诊医学学术年会论文集,2014:1.
[12] 王华庆,安志杰.肺炎球菌性疾病免疫预防专家共识(2017版)[J].中国预防医学杂志,2018,19(3):161-191.
[13] 李娜,盛柯杰,彭贵鑫,等.参附注射液辅助抗生素对重症肺炎病人临床症状消退时间、内皮细胞损伤程度因子及肺功能的影响[J].实用老年医学,2019,33(8):764- 767.
[14] 胡基粮,胡珺.美罗培南与亚胺培南-西司他丁钠治疗老年重度医院获得性肺炎的临床疗效观察[J].航空航天医学杂志,2019,30(7):771-773.
[15] 马英,乔晓霞,索磊,等.降阶梯疗法治疗新生儿重症感染性肺炎的临床疗效[J].实用临床医药杂志,2019,23(1):56-58,62.
[16] 吴刚,陈腊梅,袁华兵,等.头孢哌酮舒巴坦联合美罗培南治疗老年重症肺炎的临床疗效[J].国际老年医学杂志,2018,39(2):81-83.
[17] 杨少芬,李素,廖志勤.美罗培南对小儿重症肺炎CRP、PCT和D-二聚体水平及预后影响[J].广州医科大学学报,2020,48(6):79-81.
[18] 虎盘林,赵海平,董剑虹.美罗培南不同输注时间治疗老年住院患者获得性肺炎的临床效果比较[J].中华肺部疾病杂志(电子版),2020,13(1):75-77.
[19] 何心,刘晓艳.基于药代动力学/药效学的美罗培南应用于重症感染儿童患者中提高疗效的治疗策略[J].中国当代医药,2022,29(34):34-37.
[20] 翁朝航.亚胺培南西司他丁钠和美罗培南对重症肺部感染患者的疗效及对细菌清除率、炎症因子水平的影响[J].药品评价,2020,17(19):34-37.
[21] 年英,吕秀云.美罗培南联合莫西沙星对慢性阻塞性肺疾病并发感染性肺炎患者的影响[J].实用心脑肺血管病杂志,2019,27(3):87-90.
[22] 杨梅,严永俊,岳凤,等.亚胺培南西司他丁钠与美罗培南治疗重症肺炎临床疗效与安全性比较[J].中国药物与临床,2021,21(14):2438-2440.
[23] 刘改娥,张国霞.美罗培南对重症肺炎患者疗效及炎症反应、血小板的影响[J].血栓与止血学,2022,28(5):778-779.
[24] 刘文艳.纤维支气管镜肺泡灌洗联合美罗培南治疗重症肺部感染的效果[J].中国当代医药,2021,28(3):68- 70.
[25] 曾安津,范天琼.美罗培南联合莫西沙星治疗慢性阻塞性肺疾病并发感染性肺炎的疗效观察[J].中国医药科学,2021,11(10):71-74.
[26] 成维鹏,王磊,蔡振华,等.美罗培南持续泵入联合注射用乌司他丁治疗重症肺炎的效果[J].中国医药导报,2020, 17(25):92-95,107.
[27] 王芳,周秋云,鲁涛.亚胺培南西司他丁钠或美罗培南治疗早期肺癌合并重症肺部感染[J].中国临床研究,2022, 35(9):1305-1309.
[28] 张政,徐一鹏,朱满刚.利奈唑胺联合美罗培南治疗老年重症肺部感染患者的效果和安全性[J].中国医药,2022, 17(1):45-49.
[29] 黄飞波,徐俊龙,王婵媛,等.美罗培南对晚期非小细胞肺癌合并呼吸机相关性肺炎的疗效评价[J].中国生化药物杂志,2016,36(2):62-64. |
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