目的 观察头孢克肟胶囊联合盐酸左氧氟沙星注射液治疗老年肺炎的临床疗效。方法 选取2014年2月-2015年2月在上海市浦东医院呼吸内科就诊的老年肺炎患者106例,随机分为治疗组和对照组,每组各53例。对照组给予静脉滴注盐酸左氧氟沙星注射液,0.4 g/次,2次/d。治疗组患者在对照组治疗基础上口服头孢克肟胶囊,200 mg/次,2次/d。疗程均为14 d。比较两组治疗前后患者的临床疗效、症状改善情况、相关实验室检查。结果 治疗后,对照组和治疗组的总有效率分别为84.91%、96.23%,两组总有效率比较差异具有统计学意义(P < 0.05)。治疗后,治疗组患者临床体征如发热、咳嗽、肺部啰音消失时间均显著短于对照组,差异具有统计学意义(P < 0.05)。治疗后,治疗组患者X线胸片炎症吸收、痰培养的临床控制率、总有效率均显著优于对照组,差异具有统计学意义(P < 0.05)。治疗后,两组血清中C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)及白细胞介素-8(IL-8)水平均显著下降(P < 0.05),并且治疗组血清中CRP、TNF-α、IL-4、IL-8水平下降幅度明显高于对照组(P < 0.05)。结论 头孢克肟胶囊联合盐酸左氧氟沙星注射液治疗老年肺炎可以提高临床疗效,改善症状,控制感染,促进炎症吸收,且安全性较高,具有一定的临床推广应用价值。

Objective To observe the effect of Cefixime Capsules combined with Levofloxacin Hydrochloride Injection in the treatment of senile pneumonia. Methods Patients (106 cases) with senile pneumonia from Department of Respiratory Medicine in Shanghai Pudong Hospital from February 2014 to February 2015 were randomly divided into control and treatment groups, and each group had 53 cases. The patients in the control group were iv administered with Levofloxacin Hydrochloride Injection, 0.4 g/time, twice daily. The patients in the treatment group were po administered with Cefixime Capsules on the basis of control group, 200 mg/time, twice daily. Two groups were treated for 14 d. Symptoms improvement, clinical curative effect, and relevant laboratory examination in two groups were observed. Results After treatment, the efficacies in the control and treatment groups were 84.91% and 96.23%, respectively, and there was difference between two groups (P < 0.05). After treatment, symptoms improvements, such as extinction time of fever, cough, and pulmonary rales in the treatment group were obviously shorter than those in the control group with significant differences between two groups (P < 0.05). After treatment, clinical control rats and the efficacies of chest X-ray radiograph inflammation absorption and sputum culture in the treatment group were better than those of control group with significant differences between two groups (P < 0.05). After treatment, levels of CRP, TNF-α, IL-4, and IL-8 were obviously decreased (P < 0.05). And these indicators in treatment group improved better than those in control group, with significant difference between two groups (P < 0.05). Conclusion Cefixime Capsules combined with Levofloxacin Hydrochloride Injection in the treatment of senile pneumonia can improve the clinical curative effect, improve the symptoms, control infection, promote inflammation absorption, and has good safety, which has a certain clinical application value.