目的 探討大蒜素注射液聯(lián)合亞胺培南西司他丁鈉治療重癥社區(qū)獲得性細(xì)菌性肺炎的臨床療效。方法 選取2020年10月—2023年10月佳木斯市中醫(yī)醫(yī)院、佳木斯市中心醫(yī)院收治的80例重癥社區(qū)獲得性細(xì)菌性肺炎患者，依據(jù)用藥情況將患者分為對照組和治療組，每組各40例。對照組患者靜脈滴注注射用亞胺培南西司他丁鈉，0.5 g入0.9%氯化鈉100 mL中稀釋，2次/d。治療組在對照組的基礎(chǔ)上靜脈滴注大蒜素注射液，90 mg入0.9%氯化鈉500 mL稀釋，1次/d。兩組連續(xù)治療10 d。觀察兩組的臨床療效和癥狀好轉(zhuǎn)時間，比較兩組治療前后Murray肺損傷評分（MLIS）評分、肺部感染量表（CPIS）評分、血清降鈣素原（PCT）、高遷移率族蛋白B1（HMGB1）、白細(xì)胞介素-1β（IL-1β）、可溶性細(xì)胞間黏附分子-1（sICAM-1）、第一秒用力呼氣量（FEV₁）、用力肺活量（FVC）、第一秒用力呼氣容積占用力肺活量百分比（FEV₁/FVC%）的變化情況。結(jié)果 治療后，治療組總有效率是95.00%，顯著高于對照組的77.50%（P＜0.05）。治療后，治療組喘息、缺氧癥狀、咳嗽、肺部啰音好轉(zhuǎn)時間均顯著短于對照組（P＜0.05）。治療后，兩組患者MLIS評分、CPIS評分均較同組治療前顯著降低（P＜0.05）；治療后，治療組MLIS評分、CPIS評分均低于對照組（P＜0.05）。治療后，兩組血清PCT、HMGB1、IL-1β、sICAM-1水平均顯著降低（P＜0.05）；治療后，治療組患者PCT、HMGB1、IL-1β、sICAM-1水平均低于對照組（P＜0.05）。治療后，兩組FEV₁、FVC、FEV₁/FVC水平均較同組治療前顯著升高（P＜0.05）；治療后，治療組FEV₁、FVC、FEV₁/FVC水平均高于對照組（P＜0.05）。結(jié)論 大蒜素注射液聯(lián)合亞胺培南西司他丁鈉治療重癥社區(qū)獲得性細(xì)菌性肺炎具有較好的臨床療效，可減輕患者臨床癥狀，降低機體炎性因子，值得借鑒與應(yīng)用。

Objective To investigate the therapeutic effect of Allitride Injection combined with imipenem and cilastatin sodium in treatment of severe community-acquired bacterial pneumonia. Methods Eighty patients with severe community-acquired bacterial pneumonia admitted to Jiamusi Hospital of Traditional Chinese Medicine and Jiamusi Central Hospital from October 2020 to October 2023 were selected and divided into control group and treatment group according to drug usage, with 40 cases in each group. Patients in control group were iv administered with Imipenem and Cilastatin Sodium for injection, 0.5 g was diluted into 0.9% sodium chloride 100 mL, twice daily. Patients in treatment group were iv administered with Allitride Injection on the basis of control group, 90 mg was diluted with 0.9% sodium chloride 500 mL, once daily. The two groups were treated continuously for 10 d. The clinical efficacy and symptom improvement time of two groups were observed, and the changes of Murray Lung Injury score (MLIS), Pulmonary Infection Scale (CPIS) score, serum procalcitonin (PCT), high mobility group protein B1 (HMGB1), interleukin-1β (IL-1β), soluble intercellular adhesion molecule-1 (sICAM-1), forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and the percentage of forced expiratory volume in forced vital capacity in the first second (FEV₁/FVC%) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, which was significantly higher than that of the control group (77.50%, P < 0.05). After treatment, the improvement time of wheezing, hypoxia, cough and pulmonary rales in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, MLIS score and CPIS score in 2 groups were significantly lower than before treatment (P < 0.05). After treatment, MLIS score and CPIS score in treatment group were lower than those in control group (P < 0.05). After treatment, the serum levels of PCT, HMGB1, IL-1β and sICAM-1 in 2 groups were significantly decreased (P< 0.05). After treatment, the levels of PCT, HMGB1, IL-1β and sICAM-1 in treatment group were lower than those in control group (P < 0.05). After treatment, the levels of FEV₁, FVC and FEV₁/FVC in 2 groups were significantly higher than before treatment (P < 0.05). After treatment, the levels of FEV₁, FVC and FEV₁/FVC in treatment group were higher than those in control group (P < 0.05). Conclusion Allitride Injection combined with imipenem and cilastatin sodium has good clinical efficacy in treatment of severe community-acquired bacterial pneumonia, and can alleviate the clinical symptoms of patients, also can reduce the inflammatory factors, which is worthy of reference and application.

R974