目的 探讨喜炎平注射液联合亚胺培南西司他丁钠治疗老年重症肺炎的临床疗效。方法 选取2021年4月—2023年3月天津市宝坻区人民医院收治的96例老年重症肺炎患者，按随机数字表法将所有患者分为对照组和治疗组，每组各48例。对照组静脉滴注注射用亚胺培南西司他丁钠，每次将0.5 g用5%葡萄糖注射液100 mL调配为浓度为5 mg/mL的药液，3次/d。治疗组在对照组基础上静脉滴注喜炎平注射液，每次将500 mg加入5%葡萄糖注射液250 mL，1次/d。两组疗程均为14 d。观察两组临床疗效和临床表现消失时间，比较治疗前后两组肺炎胸片吸收评价量表（PCRAES）评分、临床肺部感染评分（CPIS）、呼吸频率（RR）、氧合指数（OI）及外周血中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白（CRP）和血清降钙素原（PCT）、白细胞介素-6（IL-6）水平。结果 治疗后，治疗组患者总有效率是93.75%，显著高于对照组的79.17%（P＜0.05）。治疗组咳嗽、发热、胸闷痛、肺部啰音消失时间均显著短于对照组（P＜0.05）。治疗后，两组PCRAES、CPIS评分均较治疗前显著降低（P＜0.05）；且以治疗组降低更显著（P＜0.05）。治疗后，两组RR均显著下降，而OI均显著增高（P＜0.05）；治疗后，治疗组RR显著低于对照组，OI显著高于对照组（P＜0.05）。治疗后，两组外周血NLR、CRP和血清PCT、IL-6水平均显著下降（P＜0.05）；且以治疗组下降更显著（P＜0.05）。结论 喜炎平注射液联合亚胺培南西司他丁钠治疗老年重症肺炎具有较好的临床疗效，能有效促进患者症状体征缓解，抑制肺部感染及全身炎症状态，改善呼吸功能，值得临床推广应用。

Objective To explore the clinical efficacy of Xiyanping Injection combined with imipenem cilastatin sodium in treatment of severe pneumonia in the elderly. Methods A total of 96 elderly patients with severe pneumonia admitted to Tianjin Baodi District People’s Hospital from April 2021 to March 2023 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 0.5 g was prepared with 5% glucose injection 100 mL into a concentration of 5 mg/mL, 3 times daily. Patients in the treatment group were iv administered with Xiyanping Injection on the basis of the control group, 500 mg was added to 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy and disappearance time of various clinical manifestations were evaluated, and the PCRAES score, clinical pulmonary infection score (CPIS), respiratory rate (RR), oxygenation index (OI), peripheral blood neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), serum pro calcitonin (PCT) and interleukin-6 (IL-6) levels were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 93.75%, which was significantly higher than that of the control group (79.17%, P< 0.05). The disappearance time of cough, fever, chest pain and lung rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, PCRAES and CPIS scores in both groups were significantly decreased compared with those before treatment (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). After treatment, RR decreased significantly, while OI increased significantly in both groups (P< 0.05). After treatment, RR and OI in treatment group were significantly lower than those in control group (P < 0.05). After treatment, the levels of peripheral blood NLR, CRP and serum PCT and IL-6 were significantly decreased in both groups (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). Conclusion Xiyanping Injection combined with imipenem cilastatin sodium has good clinical efficacy in treatment of severe pneumonia in the elderly, and can effectively promote the relief of symptoms and signs, also can inhibit lung infection and systemic inflammation, and can improve respiratory function, which is worthy of clinical application.

R974

天津市卫生健康重点学科专项项目（TJWJ2022XK035）