美罗培南治疗老年社区获得性肺炎的临床疗效及血浆D-二聚体水平变化

摘要

Objective To evaluate the clinical efficacy of meropenem in the treatment of elderly patients with community-acquired pneumonia ( CAP ) and the change of plasma D-dimer level. Methods 108 elderly patients with CAP were included and divided into different groups by different severity assessment criteria. The groups were administered with meropenem. The efficiency and plasma D-dimer level were observed. Results The mean D-dimer were different significantlyrn( P<0.05 ) among different pneumonia severity index ( PSI) groups. The plasma D-dimer level in PSI Ⅴ was significantly higher than PSI Ⅱ Ⅲ Ⅳ , and the level in PSI Ⅲ Ⅳ Ⅴ before treatment were remarkably higher than that after treatment ( P<0.05 ) . After treatment, the rate of recovery was 54.6%, and the effective rate was 83.3%. Conclusion Meropenem has a good safety and possesses a significant clinical effect in treatment for elderly CAP. Plasma D-dimer level could be useful for assessment of the severity of pulmonary infection.%目的 观察美罗培南治疗老年社区获得性肺炎(CAP)的临床疗效及治疗前后血浆D-二聚体水平的变化.方法 108例老年CAP患者,按病情严重程度评分标准(肺炎严重度指数-PSI)分组,均给予静脉滴注美罗培南治疗,500mg,3次/d,用药1周.评价临床效果并检测治疗前后血浆D-二聚体水平比较.结果 肺炎不同严重度指数(PSI)分级间D-二聚体水平比较,PSI V级D-二聚体显著高于Ⅱ、III、Ⅳ级,差异有统计学意义(P<0.05);III、Ⅳ、V级肺部感染控制后血浆D-二聚体水平明显下降,与治疗前比较差异有统计学意义(P<0.05).108例患者痊愈率54.6%,有效率83.3%.结论 美罗培南可作为治疗老年社区获得性肺炎的首选药物之一,血浆D-二聚体水平的监测对肺部感染的临床治疗有指导意义.