不同剂量乌司他丁联合头孢哌酮治疗重症细菌性肺炎的疗效及对炎症反应的影响
Efficacy of different doses of ulinastatin combined with cefoperazone in the treatment of severe bacterial pneumonia and its impact on inflammatory response

雒艳.不同剂量乌司他丁联合头孢哌酮治疗重症细菌性肺炎的疗效及对炎症反应的影响[J].内科急危重症杂志,2026,32(2):172-176

DOI：10.11768/nkjwzzzz20260214

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作者	单位	E-mail
雒艳		104113024@qq.com

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中文摘要:

摘要目的：探讨不同剂量乌司他丁联合头孢哌酮治疗重症细菌性肺炎（SBP）的疗效及对炎症反应的影响。方法：本研究为前瞻性研究。纳入SBP患者140例，所有患者均给予基础治疗，并按照随机数字表法分为4组，每组35例。对照组给予头孢哌酮治疗，低剂量组给予乌司他丁（20万U/次 bid）+头孢哌酮，中剂量组给予乌司他丁（30万U/次 bid）+头孢哌酮，高剂量组给予乌司他丁（50万U/次 bid）+头孢哌酮。治疗7d后，比较4组临床疗效、病情转归时间、治疗前后病情严重程度 [临床肺部感染（CPIS）评分、急性生理学与慢性健康状况评估（APACHE Ⅱ评分）]、炎症反应 [超敏C反应蛋白（hs-CRP）、白介素（IL）-1β、IL-6、肿瘤坏死因子-α（TNF-α）]水平及不良反应。结果：高剂量组总有效率高于中剂量组、低剂量组、对照组（P均＜0.05）；临床症状消退时间、机械通气时间、住院时间在对照组、低剂量组、中剂量组、高剂量组中依次缩短（P均＜0.05）；治疗7 d后，CPIS、APACHE Ⅱ评分、血清hs-CRP、IL-1β、IL-6、TNF-α水平在对照组、低剂量组、中剂量组、高剂量组中依次降低（P均＜0.05）；4组不良反应发生率比较，差异无统计学意义（P均＞0.05）。结论：高剂量乌司他丁联合头孢哌酮治疗SBP能显著提高疗效，减轻炎症反应，且不增加不良反应。

英文摘要:

Abstract Objective: To investigate the efficacy of different doses of ulinastatin combined with cefoperazone in the treatment of severe bacterial pneumonia (SBP) and its impact on inflammatory response. Methods: A prospective study was used in this study. A total of 140 patients with SBP were included. All patients were given basic treatment and divided into 4 groups using the random number table, with 35 cases in each group. The control group was treated with cefoperazone, the low-dose group was treated with ulinastatin (200,000 U/time, bid) + cefoperazone, the medium-dose group was treated with ulinastatin (300,000 U/time, bid) + cefoperazone, and the high-dose group was treated with ulinastatin (500,000 U/time, bid) + cefoperazone. After 7 days of treatment, the clinical efficacy, disease outcome time, as well as the levels of severity of disease [clinical pulmonary infection (CPIS) score, acute physiological assessment and chronic health evaluation (APACHE II score)], inflammatory response [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α)] before and after treatment, and adverse reactions were compared among the four groups. Results: The total effective rate of the high-dose group was higher than that of the medium-dose group, the low-dose group and the control group (P< 0.05). The regression time of clinical symptoms, mechanical ventilation time and hospitalization time were shortened in turn in the control group, low-dose group, medium-dose group and high-dose group (P< 0.05). After 7 days of treatment, CPIS, APACHE II score, serum hs-CRP, IL-1β, IL-6 and TNF-α levels decreased in turn in the control group, low-dose group, medium-dose group and high-dose group (P< 0.05). There was no significant difference in the incidence of adverse reactions among the four groups (P> 0.05). Conclusion: High-dose ulinastatin combined with cefoperazone in the treatment of SBP can significantly improve the curative effect, reduce the inflammatory response, and does not increase the adverse reactions.