目的 探讨大蒜素注射液联合亚胺培南西司他丁钠治疗重症社区获得性细菌性肺炎的临床疗效。方法 选取2020年10月—2023年10月佳木斯市中医医院、佳木斯市中心医院收治的80例重症社区获得性细菌性肺炎患者，依据用药情况将患者分为对照组和治疗组，每组各40例。对照组患者静脉滴注注射用亚胺培南西司他丁钠，0.5 g入0.9%氯化钠100 mL中稀释，2次/d。治疗组在对照组的基础上静脉滴注大蒜素注射液，90 mg入0.9%氯化钠500 mL稀释，1次/d。两组连续治疗10 d。观察两组的临床疗效和症状好转时间，比较两组治疗前后Murray肺损伤评分（MLIS）评分、肺部感染量表（CPIS）评分、血清降钙素原（PCT）、高迁移率族蛋白B1（HMGB1）、白细胞介素-1β（IL-1β）、可溶性细胞间黏附分子-1（sICAM-1）、第一秒用力呼气量（FEV₁）、用力肺活量（FVC）、第一秒用力呼气容积占用力肺活量百分比（FEV₁/FVC%）的变化情况。结果 治疗后，治疗组总有效率是95.00%，显著高于对照组的77.50%（P＜0.05）。治疗后，治疗组喘息、缺氧症状、咳嗽、肺部啰音好转时间均显著短于对照组（P＜0.05）。治疗后，两组患者MLIS评分、CPIS评分均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组MLIS评分、CPIS评分均低于对照组（P＜0.05）。治疗后，两组血清PCT、HMGB1、IL-1β、sICAM-1水平均显著降低（P＜0.05）；治疗后，治疗组患者PCT、HMGB1、IL-1β、sICAM-1水平均低于对照组（P＜0.05）。治疗后，两组FEV₁、FVC、FEV₁/FVC水平均较同组治疗前显著升高（P＜0.05）；治疗后，治疗组FEV₁、FVC、FEV₁/FVC水平均高于对照组（P＜0.05）。结论 大蒜素注射液联合亚胺培南西司他丁钠治疗重症社区获得性细菌性肺炎具有较好的临床疗效，可减轻患者临床症状，降低机体炎性因子，值得借鉴与应用。

Objective To investigate the therapeutic effect of Allitride Injection combined with imipenem and cilastatin sodium in treatment of severe community-acquired bacterial pneumonia. Methods Eighty patients with severe community-acquired bacterial pneumonia admitted to Jiamusi Hospital of Traditional Chinese Medicine and Jiamusi Central Hospital from October 2020 to October 2023 were selected and divided into control group and treatment group according to drug usage, with 40 cases in each group. Patients in control group were iv administered with Imipenem and Cilastatin Sodium for injection, 0.5 g was diluted into 0.9% sodium chloride 100 mL, twice daily. Patients in treatment group were iv administered with Allitride Injection on the basis of control group, 90 mg was diluted with 0.9% sodium chloride 500 mL, once daily. The two groups were treated continuously for 10 d. The clinical efficacy and symptom improvement time of two groups were observed, and the changes of Murray Lung Injury score (MLIS), Pulmonary Infection Scale (CPIS) score, serum procalcitonin (PCT), high mobility group protein B1 (HMGB1), interleukin-1β (IL-1β), soluble intercellular adhesion molecule-1 (sICAM-1), forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and the percentage of forced expiratory volume in forced vital capacity in the first second (FEV₁/FVC%) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, which was significantly higher than that of the control group (77.50%, P < 0.05). After treatment, the improvement time of wheezing, hypoxia, cough and pulmonary rales in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, MLIS score and CPIS score in 2 groups were significantly lower than before treatment (P < 0.05). After treatment, MLIS score and CPIS score in treatment group were lower than those in control group (P < 0.05). After treatment, the serum levels of PCT, HMGB1, IL-1β and sICAM-1 in 2 groups were significantly decreased (P< 0.05). After treatment, the levels of PCT, HMGB1, IL-1β and sICAM-1 in treatment group were lower than those in control group (P < 0.05). After treatment, the levels of FEV₁, FVC and FEV₁/FVC in 2 groups were significantly higher than before treatment (P < 0.05). After treatment, the levels of FEV₁, FVC and FEV₁/FVC in treatment group were higher than those in control group (P < 0.05). Conclusion Allitride Injection combined with imipenem and cilastatin sodium has good clinical efficacy in treatment of severe community-acquired bacterial pneumonia, and can alleviate the clinical symptoms of patients, also can reduce the inflammatory factors, which is worthy of reference and application.

R974