CAJ | 학술논문

目的探讨磷霉素氨丁三醇散(FMT)治疗老年糖尿病合并急性泌尿系感染患者的疗效及安全性. 方法选取2012年1月至2013年3月收治的86例老年糖尿病合并急性泌尿系感染患者,其中单纯性尿路感染(急性膀胱炎)62例,复杂性尿路感染(尿路结石伴感染)24例.随机分为FMT组43例和诺氟沙星(FPA)组43例,两组治疗前泌尿系统临床症状、血白细胞、尿培养、病种等比较差异均无统计学意义(P＞0.05).FMT组给予FMT 3 g/d,FPA组给予诺氟沙星胶囊0.4g,2次/d口服,疗程均为1周,1周后未治愈患者延长疗程至2周.记录患者治疗前、治疗1、2周后临床症状、体征、血常规、尿常规、尿培养及药敏试验、肝肾功能等.根据结果判定患者的临床疗效、细菌学疗效和不良反应. 结果治疗1周后FMT组治愈28例(65.1％),显效10例(1例尿常规未正常,9例尿培养未转阴),总有效率为88.4％；FPA组治愈23例(53.5％),显效7例(均为尿培养未转阴),总有效率为69.8％；两组总有效率比较差异有统计学意义(P＜0.05).治疗2周后FMT组治愈38例(88.4％),显效2例(1例尿常规未正常,1例尿培养未转阴),总有效率为93.0％；FPA组治愈25例(58.1％),显效8例(均为尿培养未转阴),总有效率为76.7％；两组比较差异有统计学意义(P＜0.05).FMT组和FPA组细菌清除率分别为88.9％和72.7％,差异有统计学意义(P＜0.05).两组不良反应发生率分别为9.3％和14.0％,差异无统计学意义(P＞0.05). 结论 FMT对老年糖尿病合并尿路感染患者的疗效显著,安全性高.
목적 탐토린매소안정삼순산(FMT)치료노년당뇨병합병급성비뇨계감염환자적료효급안전성. 방법 선취2012년1월지2013년3월수치적86례노년당뇨병합병급성비뇨계감염환자,기중단순성뇨로감염(급성방광염)62례,복잡성뇨로감염(뇨로결석반감염)24례.수궤분위FMT조43례화낙불사성(FPA)조43례,량조치료전비뇨계통림상증상、혈백세포、뇨배양、병충등비교차이균무통계학의의(P＞0.05).FMT조급여FMT 3 g/d,FPA조급여낙불사성효낭0.4g,2차/d구복,료정균위1주,1주후미치유환자연장료정지2주.기록환자치료전、치료1、2주후림상증상、체정、혈상규、뇨상규、뇨배양급약민시험、간신공능등.근거결과판정환자적림상료효、세균학료효화불량반응. 결과 치료1주후FMT조치유28례(65.1％),현효10례(1례뇨상규미정상,9례뇨배양미전음),총유효솔위88.4％；FPA조치유23례(53.5％),현효7례(균위뇨배양미전음),총유효솔위69.8％；량조총유효솔비교차이유통계학의의(P＜0.05).치료2주후FMT조치유38례(88.4％),현효2례(1례뇨상규미정상,1례뇨배양미전음),총유효솔위93.0％；FPA조치유25례(58.1％),현효8례(균위뇨배양미전음),총유효솔위76.7％；량조비교차이유통계학의의(P＜0.05).FMT조화FPA조세균청제솔분별위88.9％화72.7％,차이유통계학의의(P＜0.05).량조불량반응발생솔분별위9.3％화14.0％,차이무통계학의의(P＞0.05). 결론 FMT대노년당뇨병합병뇨로감염환자적료효현저,안전성고.
Objective To evaluate the efficacy and safety of Fosfomycin trometamol(FMT)versus Norfloxacin(FPA)in elderly diabetic patients with acute urological tract infections.Methods From Jan.2012 to Mar.2013,eighty-six patients with uncomplicated and complicated urinary tract infection were randomized into FMT group(n =43)and FPA group(n =43).Patients in both groups were balanced with regard to baseline urinary tract symptoms,fever,leukocytosis,positive urinary culture and disease type(P＞0.05).Patients received FMT 3 g daily and Norfloxacin 0.4 g twice daily for a week.Extended treatment was given to 35 patients not cured within a week.Total treatment course should not exceed two weeks.Patient's symptoms,signs,complete blood count,urinalysis,urine culture,pharmacological sensitivity tests,renal and liver function tests were performed.Results After one week of FMT treatment,28(65.1％)cases were cured and 10 cases were improved(1 was with abnormal urinalysis,9 had positive urine culture).In total,in 38(88.4％)patients treatment was as effective;In FPA group,23(53.5％)were cured and 7 cases were improved(7 had positive urine culture).In total,there were 30(69.8％)patients classified as effective.Difference was statistically significant(P＜0.05 =.After 2 weeks of FMT treatment,38(88.4％)cases were cured and 2 patients were improved(1 was with abnormal urinalysis,1 had positive urine culture).In total,40(93.0％)patients were classified as effective.In FPA group,25(58.1％)cases were cured and in 8 patients were improved(8 had positive urine culture).In total,there were 33(76.7％)patients classified as effective;Difference was statistically significant(P＜0.05 =.Bacterial clearance rate in FMT and FPA group was 88.9％ and 72.7％,respectively.Difference was statistically significant(P＜0.05 =.The adverse reaction rates were 9.3％ and 14.0％,respectively.Difference was not statistically significant(P＞0.05).Conclusions FMT is an effective and safe antibiotic in the treatment of urinary tract infections in elderly diabetic patients.