目的 研究氨溴索联合哌拉西林舒巴坦对老年重症肺炎患者的疗效及对肺功能、白介素-8（IL-8）、嗜酸性细胞阳离子蛋白（ECP）的影响。方法 选择2013年1月-2017年12月宝鸡市中医医院收治的101例老年重症肺炎患者，随机分为两组。对照组静脉滴注哌拉西林舒巴坦，2.5 g/次，2次/d；观察组联合静脉滴注氨溴索，15 mg/次，2次/d。两组均治疗2周。比较两组的住院时间、临床症状改善时间、肺功能、IL-8和ECP水平。结果 观察组治疗的总有效率为92.00%，显著高于对照组的78.43%（P<0.05）。观察组的临床症状改善时间、平均住院时间均显著短于对照组（P<0.05）。两组治疗后的第一秒最大呼气量（FEV1）、用力肺活量（FVC）、用力呼气25%流速（MEF25）、最大呼气流速峰值（PEF）以及用力呼气50%流速（MWV50）均显著升高（P<0.05）；且观察组显著高于对照组（P<0.05）。两组治疗后的血清IL-8、ECP水平均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。结论 氨溴索联合哌拉西林舒巴坦对老年重症肺炎患者的疗效显著优于单纯使用哌拉西林舒巴坦，不仅能改善其肺功能，还能有效对抗炎症反应。

Objective To study the effect of ambroxol combined with piperacillin sulbactam on pulmonary function, IL-8 and ECP in elderly patients with severe pneumonia. Methods Selected 101 elderly patients with severe pneumonia admitted to our hospital from 2013.1-2017.12 were randomly divided into two groups. The control group was given intravenous drip of piperacillin sulbactam, and the observation group combined with intravenous infusion of ambroxol. Results The total effective rate of the observation group was significantly higher than control group (P<0.05). The clinical symptom improvement time and average hospitalization time of the observation group were shorter than the control group (P<0.05). After treatment, FEV1, FVC, MEF25, PEF and MWV50 in the two groups were significantly increased (P<0.05), and the observation group was more significant (P<0.05); The serum IL-8 and ECP levels of the two groups decreased significantly (P<0.05), and the observation group was more significant (P<0.05). Conclusion The effect of ambroxol combined with piperacillin sulbactam is significantly better than the simple use of piperacillin sulbactam, can improve the lung function, and combat the inflammatory response.

R974