Effect of tigecycline combined with amikacin on severe pneumonia and expression of serum CD40L and VCAM-1

LU Xiao-yu; LI Ai-ling; WANG Ya-hong

doi:10.3969/j.issn.1672-8157.2023.05.012

Abstract：Objective:To explore the effect of tigecycline combined with amikacin on severe pneumonia and the expression of serum CD40L and VCAM-1.Methods:A total of 125 patients with severe pneumonia who met the inclusion criteria admitted in our hospital from July 2020 to August 2021 were enrolled in this study and divided into the study group(n = 78)and the control group(n = 47)according to the different medical plans.On the basis of conventional treatment,the patients in the control group were given alkamicin nebulization treatment,and those in the study group tigecycline on the basis of the control group.Both groups were treated for 2 consecutive weeks.The clinical and microbiological efficacy and adverse reactions of the two groups were observed,and serum C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-related activated protein(CD40L),and vascular cell adhesion factor-1(VCAM-1)were detected.The platelet count(PLT),white blood cell count(WBC)and D-dimer and the acute physiology and chronic health assessment standard Ⅱ(APACHE Ⅱ)were used to evaluate the severity of the disease before and after treatment in both groups.The relationship between serum CD40L and VCAM-1 levels and serum inflammatory factors and APACHE Ⅱ score was examined.Results:The serum CRP,PCT,CD40L,VCAM-1,WBC,D-dimer and APACHE Ⅱ scores of the two groups of patients were lower after than before the treatment,and they were lower in the study group than in the control(P<0.05).The serum PLT level was higher in the observation group than in the control before the treatment(P<0.05).The serum CD40L and VCAM-1 levels were positively correlated with serum CRP,PCT levels and APACHE Ⅱ score,(r = 0.393,P = 0.000;r = 0.386,P = 0.000;r = 0.249,P = 0.005;r = 0.328,P = 0.000;r = 0.345,P = 0.000;r = 0.491,P = 0.000).The total clinical effective rate of the study group was 91.03%,which was higher than that of 74.47% in the control(χ2 = 5.237,P = 0.022).Meanwhile,the total clearance rate of the study group was 84.62%,which was higher than that of 68.09%in the control(χ2 = 4.732,P = 0.030).There was no statistical difference in adverse reactions(χ2 = 3.645,P = 0.056).Conclusion:Tigecycline combined with amikacin has a definite curative effect on severe pneumonia since it can effectively remove pathogenic bacteria in the body,reduce the body's inflammatory response and improve immune function.