Abstract: Objective　To investigate the effect of tigecycline combined with cefoperazone-sulbactam on plasma matrix metalloproteinase-9 (MMP-9), immune function, and inflammatory indicators in patients with severe intra-abdominal infection in ICU. Methods　Eighty cases of severe abdominal infection in ICU admitted to Intensive Care Department, Hospital of 73rd Group, China's People's Liberation Army from April 2016 to April 2021 were seledted as the research data, including 46 males and 34 females who were (61.57±4.08) years old, and were randomly divided into a control group and an observation group by lottery, with 40 cases in each group. The control group were treated with cefoperazone-sulbactam, and the observation group with tigecycline and cefoperazone-sulbactam. The therapeutic effects and incidences of adverse reactions of the two groups were compared. χ² and t tests were applied. Results　The effective rate was 92.50% (37/40) in the observation group, and was 75.00% (30/40) in the control group, with a statistical difference (χ²=4.500, P<0.05). After the treatment, the levels of MMP-9, Toll-like receptors-4 (TLR-4), and collagen type Ⅳ (Ⅳ-C) were lower than those before the treatment in both groups, and were lower in the observation group than in the control group, with statistical differences (t=8.886, 9.097, and 10.124; all P<0.05). After the treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) were lower than those before the treatment in both groups, and were lower in the observation group than in the control group, with statistical differences (t=7.858, 3.807, and 5.396; all P<0.05). After the treatment, the levels of CD3+ and CD4+ and CD4+/CD8+ increased in both groups, and were higher in the observation group than in the control group, with statistical differences (t=3.326, 5.062, and 4.682; all P<0.05). During the treatment, 9 patients had adverse reactions, including 4 in the control group and 5 in the observation group, with no statistical difference (P>0.05). Conclusions　Tigecycline combined with cefoperazone-sulbactam for ICU patients with severe intra-abdominal infection can effectively relieve their symptoms, improve their health and immune function, and reduce the levels of plasma MMP-9, TLR-4, Ⅳ-C, and inflammatory factors and inflammatory response, and achieve definite curative effect. Combination medication does not significantly increase adverse reactions, but it needs to strengthen monitoring. It is worth being generalized.

Key words: Tigecycline, Cefoperazone-sulbactam, Abdominal infection, Therapeutic effect, Immune function, Inflammatory factors

摘要： 目的　探讨替加环素联合头孢哌酮舒巴坦治疗重症监护病房（ICU）重度腹腔感染对血浆基质金属蛋白酶-9（MMP-9）、免疫功能、炎性指标的影响。方法　选择2016年4月至2021年4月期间中国人民解放军陆军第七十三集团军医院重症医学科收治的ICU重度腹腔感染80例作为研究资料，男46例，女34例，年龄（61.57±4.08）岁，简单随机分为对照组和观察组各40例，分别采取头孢哌酮舒巴坦与替加环素联合头孢哌酮舒巴坦治疗，比较两组治疗效果及不良反应发生情况，统计学方法采用χ²检验、t检验。结果　观察组治疗有效率为92.50%（37/40），高于对照组［75.00%（30/40）］，差异有统计学意义（χ²=4.500，P<0.05）。治疗后，两组MMP-9、Toll样受体（TLR-4）、Ⅳ型胶原（Ⅳ-C）水平减少，与治疗前有明显变化，观察组3项指标水平较对照组更少，差异均有统计学意义（t=8.886、9.097、10.124，均P<0.05）。治疗后，两组C-反应蛋白（CRP）、降钙素原（PCT）、白介素-6（IL-6）水平有所减少，与治疗前比较的变化明显，对照组在3项指标水平方面与观察组相比更高，差异均有统计学意义（t=7.858、3.807、5.396，均P<0.05）。治疗后，两组T亚群细胞CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺水平有所增加，较治疗前的指标水平有明显变化，对照组的3项指标水平较观察组更少，差异均有统计学意义（t=3.326、5.062、4.682，均P<0.05）。用药治疗过程中，共有9例病患出现不良反应，其中有4例来自对照组，剩余5例来自观察组，差异无统计学意义（P>0.05）。结论　ICU重度腹腔感染患者采取替加环素联合头孢哌酮舒巴坦治疗可有效缓解症状，改善机体健康状况，并降低血浆MMP-9、TLR-4、Ⅳ-C表达，降低炎症因子水平，减轻炎性反应，改善免疫功能，取得确切的疗效，联合用药不会明显增加不良反应，但需加强监测，值得推广应用。

关键词: 替加环素, 头孢哌酮舒巴坦, 腹腔感染, 治疗效果, 免疫功能, 炎症因子