目的 观察头孢美唑联合左氧氟沙星治疗社区获得性肺炎（CAP）疗效及对患者血清降钙素原（PCT）、C反应蛋白（CRP）的影响。方法 回顾性选取 2020 年 1 月—2022 年 10 月湘潭市第一人民医院收治的 160 例 CAP 患者为研究对象，根据治疗方案不同将患者分为对照组和试验组，每组各80例。对照组患者接受乳酸左氧氟沙星氯化钠注射液治疗，静脉滴注，每次 0.4 g，静脉滴注，每天 1 次，疗程 1 周。试验组患者在对照组基础上联用注射用头孢美唑钠，静脉滴注，每次1.0～2.0 g，每天2次，疗程1周。比较两组患者的临床疗效、住院时间、抗生素使用时间、抗生素费用和治疗前后的PCT、CRP、白细胞计数（WBC）水平以及不同肺炎严重指数（PSI）患者的PCT、CRP、WBC水平，Spearman法分析CAP患者PCT、CRP、WBC 与 PSI等级的相关性。结果 试验组的有效率为 61.25%，显著高于对照组的 45.00%（P＜0.05）；试验组患者住院时间、抗生素使用时间均显著短于对照组（P＜0.05），而抗生素费用显著高于对照组（P＜0.05）。治疗前两组患者PCT、CRP、WBC水平比较，差异无统计学意义（P＞0.05）；治疗后两组患者PCT、CRP、WBC水平均较同组治疗前显著降低（P＜0.05），且试验组显著低于对照组（P＜0.05）。PSI Ⅳ级患者的 PCT、CRP 水平显著高于 PSI Ⅲ级、Ⅱ级患者（P＜0.05）；不同 PSI 等级患者的 WBC 水平比较，差异无统计学意义（P＞0.05）；血清PCT水平与PSI等级呈正相关（r＝0.538，P＜0.05），CRP、WBC与PSI等级无明显相关性（P＞0.05）。结论 头孢美唑联合左氧氟沙星治疗CAP，可缩短患者住院、用药时间，有效降低患者PCT、CRP、WBC水平。血清PCT水平与PSI等级呈正相关。

Objective To study the efficacy of cefmetazole combined with levofloxacin in treatment of community-acquired pneumonia (CAP) and its effect on serum procalcitonin (PCT) and C-reactive protein (CRP).Methods A total of 160 CAP patients admitted to Xiangtan City First People's Hospital from January 2020 to October 2022 were randomly divided into control group and experimental group, 80 cases in each group. Patients in the control group were treated with Levofloxacin Lactate Sodium Chloride Injection, intravenous drip of 0.4 g each time, once a day, for one week. On the basis of the control group, patients in the experimental group were given Cefmetazole Sodium for Injection by intravenous drip of 1.0—2.0 g twice a day for one week. Clinical curative effect, hospitalization time, usage time and cost of antibiotics, and levels of PCT, CRP and white blood cell count (WBC) before and after treatment between the two groups, as well as PCT, CRP and WBC levels in patients with different grades of pneumonia severity index (PSI) were compared. The correlation between PCT, CRP, WBC and PSI grades in patients was analyzed by Spearman method.Results The effective rate of experimental group was higher than that of control group (61.25% vs 45.00%) (P < 0.05). The hospitalization time and usage time of antibiotics in experimental group were shorter than those in control group, while antibiotics cost was higher than that in control group (P < 0.05). Before treatment, there was no significant difference in the levels of PCT, CRP and WBC between 2 groups (P > 0.05). After treatment, the levels of PCT, CRP and WBC in two groups were significantly decreased compared with before treatment (P < 0.05), and the experimental group was significantly lower than the control group (P < 0.05). The levels of PCT and CRP in patients at grade IV of PSI were higher than those at grade III and II (P < 0.05). There was no significant difference in WBC level among patients with different PSI grades (P > 0.05). The levels of serum PCT was positively correlated with PSI grades (r = 0.538, P < 0.05). While levels of serum CRP and WBC was not significantly correlated with PSI grades (P > 0.05).Conclusion Cefmetazole combined with levofloxacin in treatment of CAP, which can effectively reduce levels of PCT, CRP and WBC, shorten hospitalization time and usage time of antibiotics. The content of serum PCT is positively correlated with PSI grades.

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