目的 觀察頭孢美唑聯(lián)合左氧氟沙星治療社區(qū)獲得性肺炎（CAP）療效及對患者血清降鈣素原（PCT）、C反應(yīng)蛋白（CRP）的影響。方法 回顧性選取 2020 年 1 月—2022 年 10 月湘潭市第一人民醫(yī)院收治的 160 例 CAP 患者為研究對象，根據(jù)治療方案不同將患者分為對照組和試驗(yàn)組，每組各80例。對照組患者接受乳酸左氧氟沙星氯化鈉注射液治療，靜脈滴注，每次 0.4 g，靜脈滴注，每天 1 次，療程 1 周。試驗(yàn)組患者在對照組基礎(chǔ)上聯(lián)用注射用頭孢美唑鈉，靜脈滴注，每次1.0～2.0 g，每天2次，療程1周。比較兩組患者的臨床療效、住院時(shí)間、抗生素使用時(shí)間、抗生素費(fèi)用和治療前后的PCT、CRP、白細(xì)胞計(jì)數(shù)（WBC）水平以及不同肺炎嚴(yán)重指數(shù)（PSI）患者的PCT、CRP、WBC水平，Spearman法分析CAP患者PCT、CRP、WBC 與 PSI等級的相關(guān)性。結(jié)果 試驗(yàn)組的有效率為 61.25%，顯著高于對照組的 45.00%（P＜0.05）；試驗(yàn)組患者住院時(shí)間、抗生素使用時(shí)間均顯著短于對照組（P＜0.05），而抗生素費(fèi)用顯著高于對照組（P＜0.05）。治療前兩組患者PCT、CRP、WBC水平比較，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療后兩組患者PCT、CRP、WBC水平均較同組治療前顯著降低（P＜0.05），且試驗(yàn)組顯著低于對照組（P＜0.05）。PSI Ⅳ級患者的 PCT、CRP 水平顯著高于 PSI Ⅲ級、Ⅱ級患者（P＜0.05）；不同 PSI 等級患者的 WBC 水平比較，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）；血清PCT水平與PSI等級呈正相關(guān)（r＝0.538，P＜0.05），CRP、WBC與PSI等級無明顯相關(guān)性（P＞0.05）。結(jié)論 頭孢美唑聯(lián)合左氧氟沙星治療CAP，可縮短患者住院、用藥時(shí)間，有效降低患者PCT、CRP、WBC水平。血清PCT水平與PSI等級呈正相關(guān)。

Objective To study the efficacy of cefmetazole combined with levofloxacin in treatment of community-acquired pneumonia (CAP) and its effect on serum procalcitonin (PCT) and C-reactive protein (CRP).Methods A total of 160 CAP patients admitted to Xiangtan City First People's Hospital from January 2020 to October 2022 were randomly divided into control group and experimental group, 80 cases in each group. Patients in the control group were treated with Levofloxacin Lactate Sodium Chloride Injection, intravenous drip of 0.4 g each time, once a day, for one week. On the basis of the control group, patients in the experimental group were given Cefmetazole Sodium for Injection by intravenous drip of 1.0—2.0 g twice a day for one week. Clinical curative effect, hospitalization time, usage time and cost of antibiotics, and levels of PCT, CRP and white blood cell count (WBC) before and after treatment between the two groups, as well as PCT, CRP and WBC levels in patients with different grades of pneumonia severity index (PSI) were compared. The correlation between PCT, CRP, WBC and PSI grades in patients was analyzed by Spearman method.Results The effective rate of experimental group was higher than that of control group (61.25% vs 45.00%) (P < 0.05). The hospitalization time and usage time of antibiotics in experimental group were shorter than those in control group, while antibiotics cost was higher than that in control group (P < 0.05). Before treatment, there was no significant difference in the levels of PCT, CRP and WBC between 2 groups (P > 0.05). After treatment, the levels of PCT, CRP and WBC in two groups were significantly decreased compared with before treatment (P < 0.05), and the experimental group was significantly lower than the control group (P < 0.05). The levels of PCT and CRP in patients at grade IV of PSI were higher than those at grade III and II (P < 0.05). There was no significant difference in WBC level among patients with different PSI grades (P > 0.05). The levels of serum PCT was positively correlated with PSI grades (r = 0.538, P < 0.05). While levels of serum CRP and WBC was not significantly correlated with PSI grades (P > 0.05).Conclusion Cefmetazole combined with levofloxacin in treatment of CAP, which can effectively reduce levels of PCT, CRP and WBC, shorten hospitalization time and usage time of antibiotics. The content of serum PCT is positively correlated with PSI grades.

R974