目的:探讨多粘菌素静滴联合雾化吸入对鲍曼不动杆菌感染性VAP患者炎症反应进程的影响。方法:收集在本院接受住院治疗的鲍曼不动杆菌感染性VAP患者60例,随机分为对照组、观察组各30例。对照组患者接受常规治疗,观察组患者接受常规治疗＋多粘菌素静滴联合雾化吸入,持续治疗2周。对比两组患者治疗前后血清中急性时相反应蛋白、氧化应激指标、炎症反应指标含量的差异。结果:治疗前,两组血清中急性时相反应蛋白、氧化应激指标、炎症反应指标含量的差异无统计学意义(P＞0.05)。治疗2周后,观察组血清中急性时相反应蛋白PA的含量高于对照组,CRP、CER的含量低于对照组；血清中氧化应激指标MDA、LHP的含量低于对照组,SOD的含量高于对照组；血清中炎症反应指标IL-1、IL-6、IL-8、TNF-α的含量低于对照组(P＜0.05)。结论:鲍曼不动杆菌感染性VAP患者接受多粘菌素静滴联合雾化吸入,可有效抑制机体全身炎症反应进程,促进疾病康复。

Objective: To explore the influence of polymyxin intravenous drip combined with aerosol inhalation on the inflammatory response process in patients with Acinetobacter baumannii infectious VAP. Methods: 60 patients with Acinetobacter baumannii infectious VAP who received hospitalization in the hospital between January 2014 and January 2017 were collected and divided into control group and observation group by random number table, 30 cases in each group. Control group of patients received conventional therapy, observation group of patients received conventional therapy + polymyxin intravenous drip combined with aerosol inhalation, and the therapy lasted for 2 weeks. The differences in serum levels of acute phase proteins, oxidative stress indexes and inflammatory response indexes were compared between the two groups before and after treatment. Results:Before treatment, the differences in serum levels of acute phase proteins, oxidative stress indexes and inflammatory response indexes were not statistically significant between the two groups of patients (P＞0.05). After 2 weeks of treatment, serum acute phase protein PA level of observation group was higher than that of control group while CRP and CER levels were lower than those of control group; serum oxidative stress indexes MDA and LHP levels were lower than those of control group while SOD level was higher than that of control group; serum inflammatory response indexes IL-1, IL-6, IL-8 and TNF-α levels were lower than those of control group (P<0.05). Conclusion: Polymyxin intravenous drip combined with aerosol inhalation can inhibit the systemic inflammatory response process and promote the disease recovery in patients with Acinetobacter baumannii infectious VAP.

R563.1

武汉市卫生局科研项目(wx12c35)