中国中西医结合急救杂志2025，Vol.32Issue(2)：142-148,7.DOI:10.3969/j.issn.1008-9691.2025.02.004
非甾体抗炎药联合抗菌药物降低创伤性脓毒症发生率
The combination of nonsteroidal anti-inflammatory drug and antibiotics decreases the incidence of traumatic sepsis:a single-centre retrospective study
摘要
Abstract
Objective To investigate the therapeutic potential and prophylactic value of concomitant administration of nonsteroidal anti-inflammatory drug(NSAID)and antimicrobial agents in mitigating the incidence and severity of trauma-induced sepsis.Methods A retrospective cohort study encompassed the collection of clinical records from trauma patients managed in the department of intensive care unit(ICU)of Daping Hospital,Army Medical University(Third Military Medical University)from June 2008 to June 2024.Based on administered therapeutic protocols,patients were stratified into a control group(receiving antibiotic monotherapy)and a experimental group(undergoing adjunctive therapy with NSAID in conjunction with antimicrobial agents).Intergroup comparisons were performed to elucidate differences in baseline clinical characteristics and laboratory indices pertinent to therapeutic outcomes.Results A total of 268 trauma patients were included,with 72 patients in the control group and 196 patients in the experimental group.The majority of cases involved open trauma(67.5%)and injuries sustained from traffic accidents(44.0%),reflecting the principal mechanisms of injury.The respiratory tract was the most common site of infection(67.5%),with Acinetobacter baumannii(A.baumannii)emerging as the leading causative microorganism(18.0%).Among therapeutic agents,ibuprofen represented the most frequently employed NSAID(59.8%),whereas cephalosporins constituted the predominant class of antimicrobials(30.5%).Following intervention,the lymphocyte percentage(LYM%)was markedly elevated in the experimental group relative to control group[0.14(0.09,0.20)vs.0.12(0.09,0.15),P<0.01].In contrast,the levels of white blood cell count(WBC),neutrophil percentage(NEU%),D-dimer,glucose(Glu),and lactic acid(Lac)were significantly reduced[WBC(×109/L):8.82(6.36,12.96)vs.12.10(7.78,15.54);NEU%:0.76(0.67,0.81)vs.0.78(0.72,0.83);D-dimer(μg/L):2208.0(889.5,3301.5)vs.2943.9(1735.4,4997.6);Glu(mmol/L):6.8(6.2,7.9)vs.7.7(6.6,9.2);Lac(mmol/L):0.9(0.6,1.2)vs.1.1(0.8,1.5),all P<0.05].The experimental group demonstrated a significantly reduced incidence of traumatic sepsis compared with the control group[15.8%(31/196)vs.26.4%(19/72),P<0.05].Conclusion The combination of NSAID and antimicrobial agents exerts its protective effect by attenuating inflammatory and stress responses,reestablishing immune homeostasis,correcting coagulopathy,and enhancing tissue perfusion,thereby significantly decreasing the incidence of traumatic sepsis and contributing to improved prognostic outcomes in injured patients.关键词
非甾体抗炎药/抗菌药物/创伤性脓毒症/单中心/回顾性队列研究Key words
Nonsteroidal anti-inflammatory drug/Antimicrobial therapeutics/Traumatic sepsis/Single-institution/Retrospective cohort analysis引用本文复制引用
谢开晶,严军,余静,夏雨,康露,刘国昌,陈代琦,王震,王耀丽..非甾体抗炎药联合抗菌药物降低创伤性脓毒症发生率[J].中国中西医结合急救杂志,2025,32(2):142-148,7.基金项目
重庆市技术创新与应用发展专项重点项目(CSTC2021jscx-gksb-N0007) （CSTC2021jscx-gksb-N0007）
陆军军医大学(第三军医大学)科技创新能力提升专项军事医学预研项目(2019XYY22) The Key Project of Technological Innovation and Application Development in Chongqing(CSTC2021jscx-gksb-N0007) （第三军医大学）
Science and Technology Innovation Enhancement Project of Army Medical University(Third Military Medical University)(2019XYY22) （Third Military Medical University）
