| 淡海丽,易飞,赖海燕.莫西沙星对老年下呼吸道感染病人的疗效及并发低钾血症的危险因素分析[J].安徽医药,2026,30(1):188-192. |
| 莫西沙星对老年下呼吸道感染病人的疗效及并发低钾血症的危险因素分析 |
| Efficacy of moxifloxacin in elderly patients with lower respiratory tract infection and risk factors of hypokalemia |
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| DOI：10.3969/j.issn.1009-6469.2026.01.038 |
| 中文关键词: 莫西沙星 呼吸道感染 治疗结果 低钾血症 危险因素 老年人 |
| 英文关键词: Moxifloxacin Lower respiratory tract infection Treatment outcome Hypokalemia Risk factors Aged |
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| 中文摘要: |
| 目的探讨莫西沙星对老年下呼吸道感染病人的疗效及并发低钾血症的危险因素分析。方法选取 2020年 7月至 2022年 8月成都市第三人民医院诊治的 256例老年下呼吸道感染病人作为研究对象，均予以莫西沙星治疗，观察疗效及对比治疗前后的血清；并根据病人治疗期间是否发生低钾血症分为低钾血症组( n=32)和非低钾血症组( n=224)采用 logistic回归分析探索影响老年下呼吸道感染病人并发低钾血症的危险因素。结果 256例老年下呼吸道感染病人经治疗，后总有效率为 96.88%；发热消失时间( 3.00±0.30)d、肺部啰音消失时间( 4.20±0.89)d、咳嗽咳痰消失时间( 3.57±0.77)d；且治疗后白细胞介素(IL)-6(15.42±2.39)ng/L、IL-8(19.32±3.05)ng/L、IL-10(16.28±2.47)ng/L、CD8(+21.45±2.43)%较治疗前明显降低［(66.56±12.25) ng/L、(61.47±10.96)ng/L、(25.79±4.08)%］CD4+CD4+/CD8+(76.85±14.74)ng/L、，(40.18±7.52)%、(1.87±0.29)较治疗前明显升高［( 30.21±5.43)%、1.18±0.19］(P<0.05)。于治疗期间，有 32例( 12.50%)病人并发低钾血症，食欲减退 3例( 1.17%)、腹泻 2例(0.78%)，恶心 3例( 1.17%)。低钾血症组与非低钾血症组在性别、年龄、用药时间、合并冠心病、糖尿病、高血压、抗感染药物、激素类药物、胰岛素、服药前血钾等基线资料比较中，差异无统计学意义( P>0.05)；低钾血症组的利尿剂使用率 59.38%(19/ 32)、用药前禁食率 53.13%(17/32)、用药前腹泻率 56.25%(18/32)均高于非低钾血症组［32.14%(72/224)、 23.21%(52/224)、 25.89%(58/224)(P<0.05)。logistic回归分析显示，使用利尿剂、用药前禁食、用药前腹泻是影响老年下呼吸道感染并发低钾血症的危险因素(P<0.05)。结论莫西沙星治疗老年下呼吸道感染具有较好效果，但利尿剂、禁食、腹泻等因素会增加低钾血症发生风险。 |
| 英文摘要: |
| Objective To investigate the efficacy of moxifloxacin and sodium chloride in the treatment of elderly patients with low-er respiratory tract infection and the risk factors of hypokalemia.Methods Two hundred and fifty-six elderly patients with lower re-spiratory tract infection diagnosed and treated in the Third People's Hospital of Chengdu from July 2020 to August 2022 were select-ed as the research objects, who were all treated with moxifloxacin and sodium chloride, and the efficacy was observed and the serumbefore and after treatment was compared. The patients were divided into hypokalemia group (n=32) and non hypokalemia group (n= 224) based on whether they experienced hypokalemia during treatment. Logistic regression model was used to analyze the risk factorsof hypokalemia in elderly patients with lower respiratory tract infections.Results The total effective rate of 256 elderly patients withlower respiratory tract infection after treatment was 96.88%. The disappearance time of fever was(3.00±0.30)days, the disappear-ance time of lung rales was(4.20±0.89)days, and the disappearance time of cough and phlegm was(3.57±0.77)days. After treat-ment, IL-6 (15.42±2.39) ng/L, IL-8 (19.32±3.05) ng/L, IL-10 (16.28±2.47) ng/L, and CD8+ (21.45±2.43) % were significantly lowerthan those before treatment [(66.56±12.25) ng/L, (61.47±10.96) ng/L, (76.85±14.74) ng/L, (25.79±4.08) % ], CD4+ (40.18±7.52) % and CD4+/CD8+(1.87±0.29)were significantly increased compared with those before treatment [(30.21±5.43) % , 1.18±0.19] (P < 0.05). During the treatment period, 32 patients (12.50%) developed hypokalemia, 3 had decreased appetite (1.17%), 2 had diarrhea(0.78%), and 3 had nausea (1.17%). There was no significant difference between the hypokalemia group and the non hypokalemiagroup in gender, age, medication time, coronary heart disease, diabetes, hypertension, anti infective drugs, hormone drugs, insulin,blood potassium before medication and other baseline data (P > 0.05). The diuretic usage rate of 59.38% (19/32), the fasting rate be-fore medication of 53.13% (17/32), and the diarrhea rate before medication of 56.25% (18/32) in the hypokalemia group were allhigher than those in the non-hypokalemia group [32.14% (72/224), 23.21% (52/224), 25.89% (58/224)]. The difference was statisti-cally significant (P < 0.05). Logistic regression model analysis showed that the use of diuretics, fasting before medication, and diar-rhea before medication were risk factors for lower respiratory tract infection and hypokalemia in the elderly (P < 0.05).Conclusion Moxifloxacin has a good effect in the treatment of elderly lower respiratory tract infection, but diuretic, fasting, diarrhea and other fac-tors will increase the risk of Hypokalemia. |
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