目的 探讨亚胺培南西司他丁钠联合阿奇霉素治疗小儿重症肺炎的疗效及对其血清白细胞介素(IL)-6、IL-8、C反应蛋白(CRP)水平的影响.方法 选取2015年7月至2016年8月期间我院收治的小儿重症肺炎患者78例,依据随机数字表法分为对照组和研究组,对照组采用亚胺培南西司他丁钠治疗,研究组采用亚胺培南西司他丁钠联合阿奇霉素治疗,对比观察2组患儿的治疗效果及对其血清IL-6、IL-8、CRP水平的影响.结果 治疗后研究组和对照组的治疗有效率分别为95%、77%,研究组明显高于对照组(P<0.05);研究组患儿的退热时间、肺啰音消失时间、咳嗽消失时间以及住院时间均明显少于对照组(P<0.05);治疗前2组患儿的动脉血气指标水平差异无统计学意义(P>0.05),治疗后均得到了改善,研究组患儿的动脉血氧分压(PaO2)、动脉/肺泡氧分压(a/APO2)、二氧化碳分压(PaCO2)改善情况明显优于对照组(P<0.05);2组患儿的血清炎性因子水平在治疗前无明显的差异,治疗后均得到降低,研究组患儿的血清IL-6、IL-8、CRP水平均明显低于对照组(P<0.05).结论 采用亚胺培南西司他丁钠联合阿奇霉素治疗小儿重症肺炎,可以明显提高治疗效果,改善患儿的动脉血气分析指标,降低血清IL-6、IL-8、CRP水平,促进病情好转,减少住院时间.%Objective To analyze the clinical effect of Imipenem Cilastatin Sodium and Azithromycin on chil-dren with severe pneumonia and its impact on serum IL-6,IL-8 and CRP.Methods Seventy-eight children with severe pneumonia treated from July 2015 to August 2016 in our hospital were selected.The subjects were random-ly divided into two groups.The control group took the imipenem and cilastatin sodium;the study group took the imipenem and cilastatin sodium and azithromycin.The clinical effect and the serum IL-6,IL-8 and CRP were ob-served.Results After treatment,the clinical effective rate for study group(95%)was significantly higher than control group(77%)(P <0.05);the disappearance time of fever,lung rale and cough as well as hospitalization time for study group was significantly shorter than control group(P<0.05);before treatment,the arterial blood gas indicators for two groups were not significantly different(P >0.05);after treatment,the index of PaO2,a/APO2and PaCO2for study group were even better than control group(P <0.05);before treatment,the serum inflammatory factors for two groups were not significantly different;after treatment,the index of IL-6,IL-8 and CRP for study group were lower than control group(P<0.05).Conclusion For children with severe pneumoni-a,the imipenem and cilastatin sodium and azithromycin can improve the clinical effect and arterial blood gas indica-tors,reduce the serum IL-6,IL-8 and CRP,promote their fast recovery and shorten the hospitalization time.
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