【摘要】 目的 探讨左氧氟沙星联合阿奇霉素治疗老年难治性呼吸道感染的疗效及安全性。 方法 选择2005年2月-2010年9月收治的高龄难治性呼吸道细菌感染患者68例，随机分为治疗组和对照组。治疗组34例，给予左氧氟沙星联合阿奇霉素；对照组34例，给予左氧氟沙星，两组总疗程皆为15 d。观察两组患者的临床疗效、细菌清除率和不良反应。 结果 治疗组的总有效率为64.71%，对照组总有效率为32.35%，两组差异有统计学意义（Plt;0.05） 。治疗组细菌清除率为76.19%，对照组细菌清除率为36.36%，两组差异有统计学意义（Plt;0.05） 。治疗组和对照组的不良反应发生率分别为5.88%和8.82%，差异无统计学意义（Pgt;0.05）。结论 左氧氟沙星联合阿奇霉素治疗老年难治性呼吸道感染疗效高， 能有效清除细菌， 不良反应较少， 值得临床推广应用。【Abstract】 Objective To evaluate the efficacy and safety of levofloxacin combined with azithromycin on refractory respiratory infections in elder patients. Methods A total of 68 elder patients with refractory respiratory infections in our hospital from February 2005 to September 2010 were randomly divided into two groups: treatment group (n=34) and control group (n=34). The patients in treatment group were treated with levofloxacin combined with azithromycin; while the patients in the control group were treated with levofloxacin alone. The total treatment periods of both groups were 15 days. The therapeutic efficacy, eradication rate of pathogens and the rate of aelverse reactions were observed. Results The therapeutic effect rate was 64.71% in the treatment group and 32.35% in the control group, and the difference between the two groups was statistically significant (Plt;0.05). The eradication rate of pathogens was 76.19% in the treatment group and 36.36% in the control group, and the difference was significant (Plt;0.05). The rate of the adverse reaction was 5.88% in the treatment group and 8.82% in the control group, and there were no significant differences between the two groups (Pgt;0.05). Conclusion Levofloxacin combined with Azithromycin is effective on refractory respiratory tract infection in elder patients, which can effectively remove the bacteria with few adverse reaction.
Objective To evaluate the efficacy of specific immunotherapy in combination with budesonide formoterol dry powder inhaler ( BUD/FM) in the treatment of moderate to severe bronchial asthma. Methods The data of 93 patients with moderate to severe asthma from September 2006 to September 2008 were analyzed. 46 cases who received BUD/FM therapy were recorded as a BUD/FM treatment group, and 47 cases who received BUD/FMand dustmite specific immunotherapy were recorded asa combination treatment group. After 6, 12, 18, and 24 months, asthma symptom scores, pulmonary function,effective rate, and scores of Asthma Quality of Life Questionnaire ( AQLQ) were compared in the two treatment groups. Results Compared with the BUD/FMtreatment group, the effective rate was significantlyhigher ( 83. 0% vs. 65. 2% , P lt;0. 05) , the lung function improvements in FEV1% pred and expiratory peak flow were more significant in the latter period of treatment, and AQLQ scores improved more significantly after 24 months’treatment in the combination treatment group. Conclusion For patients with moderate tosevere asthma, specific immunotherapy in combination with BUD/FMcan improve asthma symptoms and lung function with good compliance and long lasting efficacy.
【摘要】 目的 探讨老老年患者留置尿管内壁细菌生物被膜形成情况及其对导管相关感染(CRI)的影响。〖HTH〗方法〖HTSS〗 分析2007年2月—2009年10月住院的175例留置尿管患者,均为男性,年龄75~96岁,平均86岁。不同留置时间(7~15 d 53例、16~30 d 49例、31~45 d 44例、gt;45 d 29例)的尿管,于拔出尿管后运用超声震荡使尿管内表面生物被膜完全脱落,梯度稀释后进行生物被膜活菌计数,细菌的培养分类及构成比分析；采用扫描电镜观察尿管内壁细菌生物被膜形成的情况；观察尿管留置时间与生物被膜CRI的关系。结果 随着尿管留置时间的延长,尿管内表面生物被膜活菌计数呈指数趋势增长,CRI发生率有升高趋势,各置管时段组间尿管内表面生物被膜活菌计数及CRI发生率比较差异均有统计学意义(Plt;0.05)。扫描电镜见生物被膜的形成随时间的延长而明显增多。结论 细菌生物被膜形成是老老年患者留置尿管相关性尿路感染的重要致病因素,尿管留置时间越长,尿管生物被膜感染的危险性及几率越高。更换尿管或缩短留置时间仍是防止尿管生物被膜感染的主要方法。