目的 探讨盐酸溴己新注射液联合硫酸多黏菌素B治疗重症肺炎的临床疗效。方法 回顾性选取2023年8月—2025年9月邢台市中心医院重症医学科收治的85例重症肺炎患者的临床资料，根据用药方案差异分为对照组43例和治疗组42例。对照组患者给予注射用硫酸多黏菌素B，50万单位/次，2次/d。治疗组在对照组的基础上静脉滴注盐酸溴己新注射液，4 mg/次，用5%葡萄糖注射液100 mL稀释，2次/d。两组连续用药15 d。观察两组的临床疗效，比较两组症状缓解时间、白细胞（WBC）、中性粒细胞（NE）指标、临床肺部感染评分量表（CPIS）评分、CT评分、急性生理与慢性健康评分（APACHE-Ⅱ）评分、痰液性状评分、血清中性粒细胞明胶相关脂质运载蛋白（NGAL）、血浆内皮细胞特异性分子-1（ESM-1）、可溶性髓系细胞触发受体-1（sTREM-1）、血清降钙素原（PCT）水平。结果 治疗后，治疗组总有效率（95.24%）显著高于对照组（79.07%，P＜0.05）。治疗后，治疗组出现持续高热、痰量、支气管镜吸痰次数、咳嗽咳痰、肺部啰音等临床症状指标好转情况均优于对照组（P＜0.05）。治疗后，两组患者WBC、NE指标与治疗前比较均有显著降低（P＜0.05），且与对照组对比，治疗后治疗组的WBC、NE指标均降低（P＜0.05）。治疗后，两组患者CPIS评分、CT评分、APACHE-Ⅱ评分及痰液性状评分与治疗前比较均显著下降（P＜0.05），且与对照组对比，治疗组CPIS、CT、APACHE-Ⅱ及痰液性状评分均更低（P＜0.05）。治疗后，两组患者血清NGAL、ESM-1、sTREM-1、PCT水平与治疗前比较均显著降低（P＜0.05），且与对照组对比，治疗组的NGAL、ESM-1、sTREM-1、PCT水平更低（P＜0.05）。结论 盐酸溴己新注射液与硫酸多黏菌素B联合治疗重症肺炎有良好的临床效果和安全性，可以较好改善患者临床相关指标，降低血常规指标和血清细胞因子水平。

Objective To investigate the clinical efficacy of hydrochloride bromhexine combined with polymyxin B sulfate in treatment of Severe pneumonia. Methods Retrospectively, the clinical data of 85 patients with severe pneumonia admitted to the Intensive Care Unit of Xingtai Central Hospital from August 2023 to September 2025 were selected. These patients were divided into control group (43 cases) and treatment group (42 cases) based on the differences in medication regimens. Patients in control group patients were given intravenous Polymyxin B Sulfate for injection, 500 000 U per dose, twice daily. Patients in treatment group were given intravenous Bromhexine Hydrochloride Injection, 4 mg per dose, diluted with 5% glucose injection 100 mL, twice daily. Both groups continued the treatment for 15 d. The clinical efficacy of two groups was observed, and the symptom relief time, white blood cell (WBC), neutrophil (NE) indicators, clinical pulmonary infection score scale (CPIS) score, CT score, acute physiology and chronic health score (APACHE-II) score, sputum quality score, serum neutrophil gelatin-associated lipid carrier protein (NGAL), plasma endothelial cell-specific molecule-1 (ESM-1), soluble myeloid cell triggering receptor-1 (sTREM-1), and serum procalcitonin (PCT) levels were compared between two groups. Results After the treatment, the total effective rate of treatment group (95.24%) was significantly higher than that of control group (79.07%, P < 0.05). After treatment, the improvement in clinical symptom indicators such as persistent high fever, sputum volume, bronchoscopy suctioning frequency, coughing and expectoration, and pulmonary rales in the treatment group was better than that in control group (P < 0.05). After treatment, WBC and NE indicators of two groups of patients were significantly lower compared to those before treatment (P < 0.05), and compared with control group, WBC and NE indicators of treatment group were lower after treatment (P < 0.05). After treatment, CPIS score, CT score, APACHE-II score, and sputum quality score of two groups of patients were significantly lower compared to those before treatment (P < 0.05), and compared with control group, CPIS, CT, APACHE-II, and sputum quality scores of treatment group were lower (P < 0.05). After treatment, the serum NGAL, ESM-1, sTREM-1, and PCT levels of two groups of patients were significantly lower compared to those before treatment (P < 0.05), and compared with control group, the NGAL, ESM-1, sTREM-1, and PCT levels of treatment group were lower (P < 0.05). Conclusion The combination of Bromhexine Hydrochloride Injection and polymyxin B sulfate in treatment of severe pneumonia has shown good clinical efficacy and safety. It can effectively improve the clinical indicators of patients and reduce the levels of blood routine indicators and serum cytokines.

R974

河北邢台重点研发计划社会发展领域专项(2025ZC090)