阿奇霉素联合头孢唑肟治疗老年重症社区获得性肺炎合并心力衰竭的疗效

摘要

Objective To study the clinical curative effect of azithromycin combined with ceftizoxime on treatment of elderly patients with severe community acquired pneumonia and heart failure.Methods The objects of study were 80 elderly patients with se-vere acquired pneumonia complicated with heart failure who were divided into control group and observation group with 40 cases in each group;the control group used ceftizoxime intervention treatment, the observation group used azithromycin combined with ceftizoxime therapy;and then treatment effect on the two groups of patients was observed .Results The effective rate in, the observation group was 90%,higher than 70%in the control group;the difference was statistically significant (P<0.05).The incidence rate of adverse reaction was 25% in observation group higher than 20% in the control group, the difference was not statistically significant. Conclusions The azithromycin and ceftizoxime used in the elderly patients with severe community acquired pneumonia and heart fail-ure can improve the treatment efficiency, lower BNP, boost LVEF,and does not increase the incidence of adverse events.It is found to be safe and effective, worthy to be recommended.%目的：分析阿奇霉素联合头孢唑肟治疗老年重症社区获得性肺炎（ community acquired pneumonia，CAP）合并心力衰竭的临床疗效。方法选取我院收治的80例老年重症CAP合并心力衰竭患者，按入院先后顺序分为对照组和观察组，每组40例，对照组采用头孢唑肟干预治疗，观察组采用阿奇霉素联合头孢唑肟治疗，观察治疗前后彩色多普勒超声心动图测定左室舒张末期内径（ left ventricular end diastolic diameter， LVEDD），左室收缩末期内径（ left ventricular end systolice diameter， LVESD）和左室射血分数（ left ventricular ejection fraction，LVEF）等心功能指标的变化，观察并分析两组治疗效果及不良反应。结果观察组治疗有效率达90．0％，明显高于对照组（70．0％），差异有统计学意义（P＜0．05）。两组不良反应发生率观察组（25．0％）略高于对照组（20．0％），差异无统计学意义。两组治疗后与治疗前相比，数值均明显下降，差异有统计学意义（P＜0．05）。观察组治疗后LVEDD、LVESD、BNP含量分别为（38．56±6．47）mm，（20．46±3．82）mm，（172．00±63．00）ng ／L，均明显低于对照组（43．53±6．62）mm，（24．51±3．44）mm，（212．00±65．00）ng／L，两组比较差异有统计学意义（P＜0．05）；观察组治疗后LVEF为（76．58±6．24）％，明显高于对照组的（68．49±5．63）％，差异有统计学意义（ P＜0．05）。结论阿奇霉素联合头孢唑肟可以明显提高老年重症CAP合并心力衰竭患者的治疗有效率，改善临床症状，能够降低BNP值，提高LVEF，对纠正心力衰竭安全有效，值得临床推广。