【摘要】 目的：探討哌拉西林鈉/他唑巴坦聯(lián)合莫西沙星治療慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）合并急性下呼吸道感染患者的臨床療效。方法：選取COPD合并急性下呼吸道感染患者120例，按照隨機(jī)數(shù)字表法將其分為對(duì)照1組（哌拉西林鈉/他唑巴坦）、對(duì)照2組（莫西沙星）和聯(lián)合治療組（哌拉西林鈉/他唑巴坦+莫西沙星），每組各40例。比較三組治療前后的急性生理與慢性健康評(píng)分（APACHEⅡ）及呼吸困難評(píng)分，比較三組患者經(jīng)治療后的細(xì)菌清除率及臨床療效。結(jié)果：治療后，聯(lián)合治療組患者APACHEⅡ與呼吸困難評(píng)分均明顯低于對(duì)照1、2組，比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；三組患者治療后病原菌株數(shù)均有所下降，聯(lián)合治療組細(xì)菌清除率為91.6%（33/36），均高于對(duì)照1、2組的62.6%（23/37）、64.8%（24/37），比較差異有統(tǒng)計(jì)學(xué)意義（ 字2=9.746，P=0.008）；聯(lián)合治療組總有效率為87.5%，均高于對(duì)照1、2組的57.5%、55.0%，比較差異有統(tǒng)計(jì)學(xué)意義（ 字2=9.691，P=0.008）。結(jié)論：合理聯(lián)合使用抗生素治療COPD合并急性下呼吸道感染可減少不必要的細(xì)菌侵入，改善其預(yù)后。
　　【關(guān)鍵詞】 哌拉西林鈉/他唑巴坦； 莫西沙星； 慢性阻塞性肺疾��； 感染
　　Piperacillin Sodium/Tazobactam Combined with Moxifloxacin in Treatment of COPD with Acute Lower Respiratory Tract Infection/SUN Wenjun.//Medical Innovation of China，2018，15（07）：017-020
　　【Abstract】 Objective：To investigate the clinical efficacy of Piperacillin Sodium/Tazobactam combined with Moxifloxacin in treatment of chronic obstructive pulmonary disease（COPD） with acute lower respiratory tract infection.Method：A total of 120 patients with COPD with acute lower respiratory tract infection were selected.According to the random number table method，they were divided into control 1 group（Piperacillin Sodium/Tazobactam），control 2 group（Moxifloxacin） and combined treatment group（Piperacillin Sodium/Tazobactam+Moxifloxacin），40 cases in each group.The acute physiology and chronic health score（APACHEⅡ） and dyspnea score before and after treatment in three groups were compared，the bacterial clearance rate，and clinical efficacy of three groups after treatment were compared.Result：After treatment，the scores of APACHE Ⅱ and dyspnea in combined treatment group were significantly lower than those of control 1 and 2 group，the difference was statistically significant（P<0.05）.The number of pathogens in three groups decreased after treatment，the bacterial clearance rate in combined treatment group was 91.6%（33/36），which was higher than 62.6%（23/37） and 64.8%（24/37） in the control 1 and 2 group，the difference was statistically significant（ 字2=9.746，P=0.008）.The total effective rate of combined treatment group was 87.5%，which was higher than 57.5% and 55.0% in control group 1 and 2 group，the difference was statistically significant（ 字2=9.691，P=0.008）.Conclusion：Rational combination of antibiotics in treatment of COPD with acute lower respiratory tract infection can reduce the unnecessary bacterial invasion and improve its prognosis.
　　【Key words】 Piperacillin Sodium/Tazobactam； Moxifloxacin； Chronic obstructive pulmonary disease； Infection

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