【摘要】 目的：探讨氟喹诺酮类和非氟喹诺酮类抗生素在非复杂慢性阻塞性肺疾病急性加重期（AECOPD）中的临床效果，为临床上抗生素选择方向提供证据，从而促进优选方案的形成。方法：选择2018年1月—2020年12月东台市人民医院收治的168例非复杂AECOPD患者作为研究对象，根据是否应用氟喹诺酮类抗生素将其分为氟喹诺酮治疗组76例和非氟喹诺酮治疗组92例。非氟喹诺酮治疗组患者抗生素治疗的选择范围在阿莫西林、第二代或第三代头孢菌素、大环内酯类内，比较两组患者的临床状态、炎症因子水平、肺通气功能、X线片好转率、住院时间、不良反应发生情况以及1年内再次进院就诊次数。结果：氟喹诺酮治疗组患者的咳嗽、咳痰、气喘、双肺干湿啰音改善时间均高于非氟喹诺酮治疗组患者，差异均有统计学意义（Z=2.406、2.899、2.489、2.122,P<0.05）。治疗后，氟喹诺酮治疗组患者的PaO₂水平均低于非氟喹诺酮治疗组患者，差异均有统计学意义（t=-2.302,P<0.05）。氟喹诺酮治疗组患者肺部X线片好转率低于非氟喹诺酮治疗组患者，差异均有统计学意义（χ²=4.660,P<0.05）。氟喹诺酮治疗组患者住院时间长于非氟喹诺酮治疗组患者，差异有统计学意义（Z=2.034,P<0.05）。氟喹诺酮治疗组患者不良反应发生率高于非氟喹诺酮治疗组患者，差异有统计学意义（χ²=4.831,P<0.05）。氟喹诺酮治疗组患者再次入院门诊就诊、住院就诊次数均高于非氟喹诺酮治疗组患者，差异均有统计学意义（Z=1.965、2.150,P<0.05）。结论：氟喹诺酮类抗生素治疗非复杂AECOPD患者的临床疗效、安全性及预后效果不如非氟喹诺酮类抗生素。更多还原

【Abstract】 Objective:To investigate the clinical effects of fluoroquinolone and non-fluoroquinolone in uncomplicated acute exacerbations of COPD,so as to provide evidence for the direction of clinical antibiotic selection,and improve favorable project Methods:168 patients with AECOPD in the hospital from January 2018 to December 2020 were chosen,and divided into fluoroquinolone treatment group and non-fluoroquinolone treatment group.In the non-fluoroquinolone treatment group,the therapeutic range of antibiotics was amoxicillin,second or third generation cephalosporins and macrolides.The clinical status levels of inflammatory cytokines,pulmonary ventilation function,X-ray film improvement rate,length of hospitalization,incidence of adverse reactions and the number of re-admission to hospital within 1 year were compared between the two groups.Results:The improvement time of cough,sputum,asthma and dry and wet rales of both lungs in fluoroquinolone treatment group was higher than that in non-fluoroquinolone treatment group,and the difference was statistically significant （Z=2.406,2.899,2.489,2.122;P<0.05）.After treatment,PaO₂ level in fluoroquinolone treatment group was lower than that in non-fluoroquinolone treatment group and the difference was statistically significant （t=-2.302,P<0.05）.The improvement rate of lung X-ray film in fluoroquinolone treatment group was lower than that in non-fluoroquinolone treatment group,and the difference was statistically significant （χ²=4.660,P<0.05）.The hospitalization stay in fluoroquinolone treatment group was longer than that in non-fluoroquinolone treatment group,and the difference was statistically significant （Z=2.034,P<0.05）.The incidence of adverse reactions in fluoroquinolone treatment group was higher than that in non-fluoroquinolone treatment group,and the difference was statistically significant （χ²=4.831,P<0.05）.The number of outpatient and inpatient readmissions in fluoroquinolone treatment group was higher than that in non-fluoroquinolone treatment group,and the difference was statistically significant （Z=1.965,2.150;P<0.05）.Conclusion:Fluoroquinolones are inferior to non-fluoroquinolones in the treatment of uncomplicated AECOPD in clinical efficacy,safety and prognosis.更多还原