目的 研究氨溴索聯(lián)合哌拉西林舒巴坦對老年重癥肺炎患者的療效及對肺功能、白介素-8（IL-8）、嗜酸性細胞陽離子蛋白（ECP）的影響。方法 選擇2013年1月-2017年12月寶雞市中醫(yī)醫(yī)院收治的101例老年重癥肺炎患者，隨機分為兩組。對照組靜脈滴注哌拉西林舒巴坦，2.5 g/次，2次/d；觀察組聯(lián)合靜脈滴注氨溴索，15 mg/次，2次/d。兩組均治療2周。比較兩組的住院時間、臨床癥狀改善時間、肺功能、IL-8和ECP水平。結果 觀察組治療的總有效率為92.00%，顯著高于對照組的78.43%（P<0.05）。觀察組的臨床癥狀改善時間、平均住院時間均顯著短于對照組（P<0.05）。兩組治療后的第一秒最大呼氣量（FEV1）、用力肺活量（FVC）、用力呼氣25%流速（MEF25）、最大呼氣流速峰值（PEF）以及用力呼氣50%流速（MWV50）均顯著升高（P<0.05）；且觀察組顯著高于對照組（P<0.05）。兩組治療后的血清IL-8、ECP水平均顯著降低（P<0.05），且觀察組顯著低于對照組（P<0.05）。結論 氨溴索聯(lián)合哌拉西林舒巴坦對老年重癥肺炎患者的療效顯著優(yōu)于單純使用哌拉西林舒巴坦，不僅能改善其肺功能，還能有效對抗炎癥反應。

Objective To study the effect of ambroxol combined with piperacillin sulbactam on pulmonary function, IL-8 and ECP in elderly patients with severe pneumonia. Methods Selected 101 elderly patients with severe pneumonia admitted to our hospital from 2013.1-2017.12 were randomly divided into two groups. The control group was given intravenous drip of piperacillin sulbactam, and the observation group combined with intravenous infusion of ambroxol. Results The total effective rate of the observation group was significantly higher than control group (P<0.05). The clinical symptom improvement time and average hospitalization time of the observation group were shorter than the control group (P<0.05). After treatment, FEV1, FVC, MEF25, PEF and MWV50 in the two groups were significantly increased (P<0.05), and the observation group was more significant (P<0.05); The serum IL-8 and ECP levels of the two groups decreased significantly (P<0.05), and the observation group was more significant (P<0.05). Conclusion The effect of ambroxol combined with piperacillin sulbactam is significantly better than the simple use of piperacillin sulbactam, can improve the lung function, and combat the inflammatory response.

R974