Effect of Meropenem Combined with Bronchoalveolar Lavage in Treatment of Severe Pulmonary Infection
Objective:To investigate the effect of Meropenem combined with bronchoalveolar lavage(BAL)on severe pulmonary infection and the expression of miR-127-5p and miR-3686 in alveolar lavage fluid.Method:A total of 84 patients with severe pulmonary infection admitted to Fuzhou Changle District Hospital from January 2020 to August 2022 were selected and divided into control group(BAL)and observation group(BAL combined with Meropenem)by random number table method,with 42 cases in each group.The total effective rate,pulmonary function index,arterial blood gas analysis index,serum correlation index and the expression levels of miR-127-5p and miR-3686 in alveolar lavage fluid were compared between the two groups.Result:The total effective rate of treatment in the observation group(95.24%)was higher than that in the control group(80.95%),the difference was statistically significant(P<0.05).After 14 d of treatment,the maximum ventilation volume per minute(MVV),functional residual volume(FRC),forced expiratory volume at 1 second(FEV1),maximum mid expiratory flow(MMEF),and lung volume(LC)of both groups increased,those of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).After 14 d of treatment,the arterial oxygen partial pressure(PaO2)and arterial oxygen saturation(SaO2)of both groups increased,and those of the observation group were higher than those of the control group,the arterial carbon dioxide partial pressure(PaCO2)decreased,and that of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05);there was no statistically significant difference in pH values between the two groups compared to the same group before treatment(P>0.05),and there was no statistically significant difference between the groups after 14 d of treatment(P>0.05).After 14 d of treatment,the levels of tumor necrosis factor-α(TNF-α),procalcitonin(PCT),C reactive protein(CRP),matrix metalloproteinase-9(MMP-9)and Toll-like receptor 4(TLR-4)on the surface of leukocytes in both groups were decreased,and those of the observation group were all lower than those of the control group,the differences were statistically significant(P<0.05).After 14 d of treatment,the levels of miR-127-5p in both groups increased,and that of the observation group was higher than that of the control group,the levels of miR-3686 in both groups decreased,and the level of miR-3686 in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Meropenem combined with BAL in the treatment of severe pulmonary infection can improve lung function and blood gas indexes,reduce inflammatory response,and regulate the expression of miR-127-5p and miR-3686 in alveolar lavage fluid,with significant effects.
Severe pulmonary infectionBronchoalveolarMeropenemLung functionArterial blood gas analysisInflammatory factors
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