【摘要】 目的 探讨左氧氟沙星联合阿奇霉素治疗老年难治性呼吸道感染的疗效及安全性。 方法 选择2005年2月-2010年9月收治的高龄难治性呼吸道细菌感染患者68例，随机分为治疗组和对照组。治疗组34例，给予左氧氟沙星联合阿奇霉素；对照组34例，给予左氧氟沙星，两组总疗程皆为15 d。观察两组患者的临床疗效、细菌清除率和不良反应。 结果 治疗组的总有效率为64.71%，对照组总有效率为32.35%，两组差异有统计学意义（Plt;0.05） 。治疗组细菌清除率为76.19%，对照组细菌清除率为36.36%，两组差异有统计学意义（Plt;0.05） 。治疗组和对照组的不良反应发生率分别为5.88%和8.82%，差异无统计学意义（Pgt;0.05）。结论 左氧氟沙星联合阿奇霉素治疗老年难治性呼吸道感染疗效高， 能有效清除细菌， 不良反应较少， 值得临床推广应用。【Abstract】 Objective To evaluate the efficacy and safety of levofloxacin combined with azithromycin on refractory respiratory infections in elder patients. Methods A total of 68 elder patients with refractory respiratory infections in our hospital from February 2005 to September 2010 were randomly divided into two groups: treatment group (n=34) and control group (n=34). The patients in treatment group were treated with levofloxacin combined with azithromycin; while the patients in the control group were treated with levofloxacin alone. The total treatment periods of both groups were 15 days. The therapeutic efficacy, eradication rate of pathogens and the rate of aelverse reactions were observed. Results The therapeutic effect rate was 64.71% in the treatment group and 32.35% in the control group, and the difference between the two groups was statistically significant (Plt;0.05). The eradication rate of pathogens was 76.19% in the treatment group and 36.36% in the control group, and the difference was significant (Plt;0.05). The rate of the adverse reaction was 5.88% in the treatment group and 8.82% in the control group, and there were no significant differences between the two groups (Pgt;0.05). Conclusion Levofloxacin combined with Azithromycin is effective on refractory respiratory tract infection in elder patients, which can effectively remove the bacteria with few adverse reaction.
Objective To investigate the role of Kv1. 5 in the pathogenesis of pulmonary hypertension simulated by hypobaria and hypoxia, and the effects of dichloroacetate ( DCA) on the Kv1. 5 expression in pulmonary arterial smooth muscle cells ( PASMCs ) and mean pulmonary arterial pressure ( mPAP) . Methods Twenty-four SD rats were randomly divided into a normal group ( N group) , a high altitude group ( HA group) , and a DCA treated group ( DCA group) . The N group were fed in normalconditions, the HA group and DCA group were fed in a hypobaria and hypoxia chamber simulated to an altitude of 5000 meters. In addition, the DCA group rats were gastric gavaged with DCA ( 70 mg · kg - 1 · d - 1 ) .Twenty-one days later, percentage of wall thickness ( WT% ) and percentage of wall area ( WA% ) of the pulmonary arteriole, mPAP, and the ratio of right ventricle / left ventricle and septum ( RV/ LV + S) were evaluated. Real-time PCR, immunohistochemistry and Western blot were carried out to detect the Kv1. 5 expression in PASMCs. Results In the HA group, WT% , and WA% of pulmonary arteriole, mPAP and RV/ ( LV + S) all increased significantly compared with the N group ( P lt;0. 01) . These changes in the DCA group were significantly lower than those in the HA group( P lt; 0. 01) . Furthermore, the protein and mRNA expression of Kv1. 5 in the PASMCs deceased significantly in the HA group compared with the N group( P lt;0. 01) , but recovered in the DCA group ( P lt;0. 01) . Conclusions The expression of Kv1. 5 in PASMCs is tremendously inhibited in rats fed in high altitude, which might be a important role of pulmonaryhypertension. DCA can inhibit the remodeling of pulmonary arterials probably by recovering Kv1. 5 expression.