利奈唑胺注射液联合低分子肝素和谷氨酰胺治疗重症肺炎的临床研究

陆伟霞

【摘要】 目的：探討利奈唑胺注射液联合低分子肝素和谷氨酰胺治疗重症肺炎的临床效果以及对血清可溶性尿激酶型纤溶酶原激活物受体（suPAR）和可溶性髓系细胞触发受体1（sTREM-1）水平的调节作用。方法：选取2016年2月-2018年8月在本院就诊的重症肺炎患者102例。按照随机数字表法将其分为对照组和观察组，各51例。两组均采取常规措施，对照组给予利奈唑胺注射液治疗，观察组在对照组基础上联合低分子肝素和谷氨酰胺治疗。连续治疗2周后，比较两组动脉血气（PaCO2、PaO2、SaO2）、急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）、肺炎严重程度（CURB65、SMART-COP评分）、临床疗效及血清suPAR和sTREM-1水平。结果：治疗后，观察组PaCO2、APACHEⅡ、CURB65、SMART-COP均评分低于对照组，PaO2、SaO2均高于对照组，差异均有统计学意义（P<0.01）;观察组总有效率为96.08%，高于对照组的82.35%（字2=4.993，P=0.025）;治疗后，观察组血清suPAR和sTREM-1水平均低于对照组（P<0.01）。结论：利奈唑胺注射液联合低分子肝素和谷氨酰胺治疗重症肺炎，可显著改善患者的动脉血气指标和疾病严重程度，提高临床疗效，且可抑制sTREM-1和suPAR水平。

【关键词】 利奈唑胺注射液; 低分子肝素; 谷氨酰胺; 重症肺炎

Clinical Study of Linezolid Injection Combined with Low Molecular Weight Heparin and Glutamine in Treatment of Severe Pneumonia/LU Weixia.//Medical Innovation of China，2019，16（19）：0-049

【Abstract】 Objective：To investigate the efficacy of Linezolid Injection combined with Low Molecular Weight Heparin and Glutamine in treatment of severe pneumonia and the effect on serum levels of soluble myeloid cell triggered receptor 1（sTREM-1）and soluble urokinase type plasminogen activator receptor（suPAR）.Method：A total of 102 patients with severe pneumonia from February 2016 to August 2018 were selected.According to the random number table method，they were divided into control group and observation group，

51 cases in each group.The control group was treated with Linezolid Injection，while observation group was treated with Low Molecular Weight Heparin and Glutamine on the basis of control group.After 2 weeks of continuous treatment，arterial blood gas（PaCO2，PaO2，SaO2），acute physiology and chronic health score Ⅱ（APACHE Ⅱ），severity of pneumonia（CURB65，SMART-COP），clinical efficacy and serum suPAR and sTREM-1 levels between two groups were compared.Result：After treatment，the scores of PaCO2，APACHE Ⅱ，CURB65 and SMART-COP scores in observation group were lower than those of control group，PaO2 and SaO2 were higher than those of control group，the differences were statistically significant（P<0.01）.The total effective rate was 96.08% in observation group，which was higher than 82.35% of control group（字2=4.993，P=0.025）.After treatment，the levels of serum suPAR and sTREM-1 in observation group were lower than those of control group（P<0.01）.

Conclusion：Linezolid Injection combined with Low Molecular Weight Heparin and Glutamine in treatment of severe pneumonia can significantly improve the arterial blood gas index and disease severity，improve clinical efficacy，and inhibit the levels of sTREM-1 and suPAR.