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目的探讨万古霉素对老年心力衰竭合并肺部感染患者的炎症因子及降钙素原(PCT)水平的影响。方法选取2015年1月—2016年12月南京军区南京总医院收治的心力衰竭合并肺部感染患者64例,随机分为两组,头孢他啶组给予头孢他啶,万古霉素组给予万古霉素,两组均治疗1周。评价两组患者治疗后的临床效果,治疗前后的脑利钠肽(BNP)、炎症因子及PCT水平的变化情况。结果万古霉素组总有效率为84.37%,明显高于头孢他啶组的68.75%,差异有统计学意义(P<0.05);治疗后两组BNP、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、PCT均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且万古霉素组BNP、TNF-a、IL-6、PCT下降更为显著,组间比较差异有统计学意义(P<0.05)。结论万古霉素具有良好的抗菌作用,对心力衰竭合并肺部感染患者具有较好的临床疗效。
Objective To investigate the effect of vancomycin on the inflammatory factors and procalcitonin (PCT) levels in elderly patients with heart failure and pulmonary infection. Methods Sixty-four patients with heart failure complicated with lung infection admitted to Nanjing General Hospital of Nanjing Military Region from January 2015 to December 2016 were randomly divided into two groups: ceftazidime was given to ceftazidime, vancomycin was given to vancomycin group, All treatment for 1 week. The clinical effects, the levels of brain natriuretic peptide (BNP), inflammatory cytokines and PCT levels before and after treatment in both groups were evaluated. Results The total effective rate of vancomycin group was 84.37%, which was significantly higher than that of ceftazidime group (68.75%), the difference was statistically significant (P <0.05). After treatment, the levels of BNP, tumor necrosis factor-α (TNF- IL-6, and PCT decreased significantly (P <0.05), and the levels of BNP, TNF-a, IL-6 and PCT in vancomycin group were more decreased Significantly, the difference between the two groups was statistically significant (P <0.05). Conclusion Vancomycin has a good antibacterial effect and has good clinical efficacy in patients with heart failure and pulmonary infection.