中国临床药学杂志

目的 探讨盐酸氨溴索联合头孢哌酮钠舒巴坦钠对社区获得性肺炎老年患者的疗效。方法 纳入2022年1月至2023年11月收治的社区获得性肺炎老年患者80例，随机分为常规组（n=40）和联合组（n=40）。常规组予头孢哌酮钠舒巴坦钠治疗，联合组予盐酸氨溴索联合头孢哌酮钠舒巴坦钠治疗，2组均连续治疗7 d。比较2组治疗后的疗效、肺功能、血清1-磷酸鞘氨醇受体3(S1PR3)水平和不良反应发生情况。结果 治疗7 d后，联合组总有效率高于常规组（P<0.05）；联合组发热、咳痰、肺部啰音症状消失所需时间均少于常规组（P<0.05），最高呼吸流速（PEF）、用力肺活量（FVC）和第1秒最大呼气容积（FEV1）均高于常规组（P<0.05），血清S1PR3水平低于常规组（P<0.05）。2组不良反应总发生率比较差异无统计学意义（P > 0.05）。结论 盐酸氨溴索联合头孢哌酮钠舒巴坦钠治疗老年患者社区获得性肺炎效果优于头孢哌酮钠舒巴坦钠单药治疗，能够更好地缓解患者症状，改善肺功能，降低血清S1PR3水平，并且具有良好的安全性。

AIM To analyze the efficacy of ambroxol hydrochloride combined with cefoperazone sodium and sulbactam sodium in the treatment of elderly community-acquired pneumonia patients. METHODS Eighty elderly patients with community-acquired pneumonia were randomly separated into the conventional group(n=40) and combined group(n=40). The conventional group received treatment with cefoperazone sodium and sulbactam sodium, while the combined group received treatment with ambroxol hydrochloride combined with cefoperazone sodium and sulbactam sodium. Both groups underwent continuous treatment for 7 days. The efficacy, changes in lung function, serum S1PR3 level, and adverse reactions were compared between the 2 groups. RESULTS After treatment, the total effective rate of the combined group was higher than the conventional group(P < 0.05). After treatment, the disappearance time of fever, sputum, and lung rales in the combined group was earlier than that in the conventional group(P < 0.05). The highest respiratory flow rate(PEF), forced vital capacity(FVC), and maximum expiratory volume in the first second(FEV1) were all higher than those in the conventional group(P < 0.05). The serum S1PR3 level was lower than that in the conventional group(P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between 2 groups(P > 0.05). CONCLUSION Ambroxol hydrochloride combined with cefoperazone sodium and sulbactam sodium has shown a more prominent effect than the simple use of cefoperazone sulbactam sodium. It has an obvious effect on symptom relief, and lung function improvement, and could further reduce the serum S1PR3 level in elderly community-acquired pneumonia patients with a good safety profile.