目的 探讨血必净注射液联合头孢他啶治疗多重耐药肺炎克雷伯杆菌肺炎的临床疗效。方法 选取2020年8月—2023年2月聊城市第二人民医院收治的106例多重耐药肺炎克雷伯杆菌肺炎患者，按随机数字表法将所有患者分为对照组和治疗组，每组各53例。对照组iv注射用头孢他啶，2 g加至0.9%生理盐水100 mL，1次/12 h。治疗组在此基础上iv血必净注射液，50 mL加入0.9%生理盐水100 mL，2次/d，每次滴注时间30～40 min。两组疗程均为14 d。观察两组临床疗和临床表现消失时间，比较两组治疗前后氧合指数（OI）、呼吸频率（RR）、肺炎胸片吸收评价量表（PCRAES）评分、全血C反应蛋白（CRP）和血清降钙素原（PCT）、白细胞介素（IL）-6、淀粉样蛋白A（SAA）水平的变化情况。结果 治疗后，治疗组总有效率是94.34%，显著高于对照组的81.13%（P＜0.05）。治疗后，两组发热、咳嗽、咳痰、肺部啰音、白细胞异常的消失时间均显著短于对照组（P＜0.05）。治疗后，两组OI均显著增高，而RR和PCRAES评分均显著降低（P＜0.05）；治疗后，治疗组OI、RR和PCRAES评分改善优于对照组（P＜0.05）。治疗后，两组全血CRP和血清PCT、IL-6、SAA水平均显著下降（P＜0.05）；治疗后，治疗组全血CRP和血清PCT、IL-6、SAA水平均显著低于对照组（P＜0.05）。结论 血必净注射液联合头孢他啶治疗多重耐药肺炎克雷伯杆菌肺炎效果确切，能有效控制患者临床表现，解除气道堵塞，增强呼吸功能，缓解肺部感染及机体炎症状态。

Objective To explore the clinical efficacy of Xuebijing Injection combined with ceftazidime in treatment of multidrug-resistant Klebsiella pneumoniae pneumonia. Methods A total of 106 patients with multidrug-resistant klebsiella pneumoniae pneumonia admitted to the Second People’s Hospital of Liaocheng from August 2020 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 53 cases in each group. Patients in control group were iv administered with Ceftazidime for injection, 2 g was added to 0.9% normal saline 100 mL, once 12 h. Patients in treatment group were po administered with Xuebijing Injection on the basis of the control group, 50 mL was added to 0.9% normal saline 100 mL, twice daily, each infusion time from 30 to 40 min. The treatment course of both groups was 14 d. Clinical treatment and disappearance time of clinical manifestations of the two groups were observed, and the changes of oxygenation index (OI), respiratory rate (RR), PCRAES score, whole blood C-reactive protein (CRP), serum procalcitonin (PCT), interleukin-6 and amyloid A (SAA) levels before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 94.34%, which was significantly higher than that of control group (81.13%, P < 0.05). After treatment, the disappearance time of fever, cough, sputum, lung rales and leukocyte abnormalities in 2 groups was significantly shorter than that in control group (P < 0.05). After treatment, OI was significantly increased in both groups, but RR and PCRAES scores were significantly decreased (P < 0.05). After treatment, the improvement of OI, RR and PCRAES scores in treatment group was better than that in control group (P < 0.05). After treatment, whole blood CRP and serum PCT, IL-6 and SAA levels in both groups were significantly decreased (P < 0.05). After treatment, whole blood CRP, serum PCT, IL-6 and SAA levels in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Xuebijing Injection combined with ceftazidime has exact effect in treatment of multidrug-resistant Klebsiella pneumoniae pneumonia, and can effectively control the clinical manifestations of patients, relieve airway blockage, enhance respiratory function, which can relieve lung infection and body inflammation.

R974

聊城市重点研发计划政策引导类项目（2022YDSF48）