美罗培南降阶梯治疗对老年呼吸衰竭合并肺部感染患者肺功能及CPIS的影响

doi:10.3969/j.issn.1671-7171.2026.02.023

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摘要 【目的】 探讨美罗培南降阶梯治疗对老年呼吸衰竭合并肺部感染患者肺功能及临床肺部感染评分(CPIS)的影响。【方法】 选取2022年8月至2024年8月本院收治的97例老年呼吸衰竭合并肺部感染患者,按治疗方法不同分为常规组(n=48)和美罗培南组(n=49)。常规组给予常规抗生素治疗,美罗培南组给予美罗培南降阶梯治疗。比较两组临床疗效、肺功能指标、动脉血气分析指标、急性生理与慢性健康状况评价Ⅱ(APACHE Ⅱ)评分、CPIS及生物标志物水平。【结果】 美罗培南组治疗有效率高于常规组(P<0.05);治疗后,美罗培南组的第1秒用力呼气容积(FEV₁)、用力肺活量(FVC)、呼气流量峰值(PEF)均高于常规组(P<0.05);美罗培南组的动脉血氧分压(PaO₂)、氧合指数(OI)均高于常规组,动脉血二氧化碳分压(PaCO₂)低于常规组(P<0.05);美罗培南组的APACHEⅡ评分、CPIS均低于常规组(P<0.05);美罗培南组的降钙素原(PCT)、正五聚蛋白3(PTX3)、高迁移率族蛋白B1(HMGB1)水平均低于常规组(P<0.05)。【结论】 美罗培南降阶梯治疗对老年呼吸衰竭合并肺部感染患者肺功能及CPIS的影响较为显著。

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	崔晓青

关键词 ：肺炎, 呼吸功能不全, 美罗培南, 呼吸功能试验

Abstract：【Objective】 To investigate the effect of meropenem de-escalation therapy on pulmonary function and clinical pulmonary infection score (CPIS) in elderly patients with respiratory failure complicated by pulmonary infection. 【Methods】 A total of 97 elderly patients with respiratory failure complicated by pulmonary infection admitted to our Hospital from August 2022 to August 2024 were enrolled. According to the treatment methods, they were divided into a conventional treatment group (n=48) and a meropenem group (n=49). The conventional group received standard antibiotic therapy, while the meropenem group was treated with meropenem de-escalation therapy. Clinical efficacy, pulmonary function, arterial blood gas parameters, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores, CPIS scores, and biomarker levels were compared between the two groups. 【Results】 The treatment efficacy in the meropenem group was significantly higher than that in the conventional group (P<0.05). After treatment, the meropenem group showed significantly higher forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and peak expiratory flow (PEF) than the conventional group (P<0.05). Arterial oxygen partial pressure (PaO₂) and oxygenation index (OI) were also higher in the meropenem group, while arterial carbon dioxide partial pressure (PaCO₂) was lower (P<0.05). The APACHE Ⅱ and CPIS scores in the meropenem group were significantly lower than those in the conventional group (P<0.05). Additionally, serum levels of procalcitonin (PCT), pentraxin-3 (PTX3), and high mobility group box protein 1 (HMGB1) in the meropenem group were significantly lower than those in the conventional group (P<0.05). 【Conclusion】 Meropenem de-escalation therapy has a significant impact on improving pulmonary function and reducing CPIS scores in elderly patients with respiratory failure complicated by pulmonary infection.

Key words： Pneumonia Respiratory Insufficiency Meropenem Respiratory Function Tests

收稿日期: 2025-12-03

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R563.1

引用本文:

崔晓青. 美罗培南降阶梯治疗对老年呼吸衰竭合并肺部感染患者肺功能及CPIS的影响[J]. 医学临床研究, 2026, 43(2): 261-264.
CUI Xiaoqing. Effect of Meropenem De-Escalation Therapy on Pulmonary Function and CPIS Score in Elderly Patients with Respiratory Failure Complicated by Pulmonary Infection. JOURNAL OF CLINICAL RESEARCH, 2026, 43(2): 261-264.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.02.023 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I2/261

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