Study On The Effect Of RMPO Alveolar Lavage On APACHEⅡ And CPIS Score In Patients With Multi-drug Resistant Organisms Pneumonia

Objective: This paper proposes to explore the therapeutic effect of human recombinant myeloperoxidase(rMPO)in patients with pneumonia caused by multi-drug resistant organisms(MDRO).Methods:52 patients diagnosed with MDRO pneumonia in ICU ward of the fourth hospital of Changsha from January 2018 to August 2019 were selected as the study object.And they were divided into two groups according to the scheme of prospective cohort study.The treatment group was rMPO alveolar levage group and the control group was stroke-physiological saline solution alveolar levage group.Analyzed the changes of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),clinical pulmonary infection score(CPIS),serum C-reactive protein(CRP)level,14 day mortality rate and total time in ICU before and after bronchoalveolar lavage,and then had the statistical analysis.Results:1.In the aspect of APACHEⅡ score,the treatment group with total multi-drug resistance organisms infection decreased significantly compared with the control group in the first week after treatment,and the difference between the two groups was statistically significant(P<0.05).The treatment group with single multidrug resistant Acinetobacterbaumannii infection decreased significantly on the first day,the third day and the first week after treatment compared with the control group.The difference between the two groups was statistically significant(P < 0.05).2.In the aspect of CPIS score,there was no significant difference between the two groups of pneumonia patients infected by total multi-drug resistance organisms and single multidrug resistance Acinetobacter baumannii at different time points(P > 0.05).3.In the aspect of CRP,the CRP value of the two groups was lower than that of the control group on the 1st and 2nd day after operation,and the difference was statistically significant(P < 0.05).4.After treatment,the APACHEⅡ score,CPIS score and CRP level in the treatment group with total multi-drug resistance organisms infection decreased in different degrees,compared with that before treatment.The APACHE Ⅱ score and CPIS score of the treatment group with single multidrug resistance Acinetobacter baumannii infection decreased in different degrees after treatment,which was compared with that before treatment.5.The 14 day mortality rates of the treatment group and the cotrol group were 10.53% and 12%,respectively.There was no significant difference between the two groups(P > 0.05).6.The length of stay in ICU of the treatment group and the cotrol group was 23.42 ± 12.92 days and 32.48 ± 18.81 days respectively,therewas no significant difference between the two groups(P > 0.05).Conclusion:1.Compared with stroke-physiological saline solution bronchoalveolar lavage,rMPO had certain significance in improving APACHEⅡ score and reducing CRP level in patients with MDRO pneumonia.However,it was not significant to improve the CPIS score,14 day mortality rate and ICU length of stay.2.The therapeutic effect of rMPO bronchoalveolar lavage on different kinds of MDRO infected pneumonia may be different.