CAJ | 학술논문

目的：评价利奈唑胺治疗耐甲氧西林金黄色葡萄球菌肺炎的疗效,分析与疗效相关的影响因素。方法将2009年1月至2013年1月在我院接受利奈唑胺治疗的47例耐甲氧西林金黄色葡萄球菌肺炎患者根据疗效分为治疗有效组和治疗失败组。比较两组患者的性别、年龄、体重、炎症指标、APACHE Ⅱ评分、动脉血氧分压和基础疾病,进而通过二元逻辑回归分析找出影响疗效的因素。结果利奈唑胺的临床总有效率为72．3%。治疗失败组的PCT值和APACHEⅡ评分更高[分别为(1．38±0．67) mg/L对(0．91±0．32)mg/L,14．3±5．7对9．8±4．1,P=0．029和0．004),动脉血氧分压更低[(66±10) mmHg对(72±8) mmHg,P=0．016]。PCT值、APACHEⅡ评分和脑血管病是影响利奈唑胺治疗耐甲氧西林金黄色葡萄球菌肺炎疗效的临床因素。PCT的OR值为2．02(P=0．034,95% CI 1．06~3．88),APACHEⅡ的OR值为1．41(P=0．013,95% CI 1．17~1．85),脑血管病的OR值为5．42(P=0．017,95% CI 1．69~42．4)。结论利奈唑胺治疗耐甲氧西林金黄色葡萄肺炎的疗效良好,而高PCT值、高APACHEⅡ评分和脑血管病是治疗失败的主要危险因素。
목적：평개리내서알치료내갑양서림금황색포도구균폐염적료효,분석여료효상관적영향인소。방법장2009년1월지2013년1월재아원접수리내서알치료적47례내갑양서림금황색포도구균폐염환자근거료효분위치료유효조화치료실패조。비교량조환자적성별、년령、체중、염증지표、APACHE Ⅱ평분、동맥혈양분압화기출질병,진이통과이원라집회귀분석조출영향료효적인소。결과리내서알적림상총유효솔위72．3%。치료실패조적PCT치화APACHEⅡ평분경고[분별위(1．38±0．67) mg/L대(0．91±0．32)mg/L,14．3±5．7대9．8±4．1,P=0．029화0．004),동맥혈양분압경저[(66±10) mmHg대(72±8) mmHg,P=0．016]。PCT치、APACHEⅡ평분화뇌혈관병시영향리내서알치료내갑양서림금황색포도구균폐염료효적림상인소。PCT적OR치위2．02(P=0．034,95% CI 1．06~3．88),APACHEⅡ적OR치위1．41(P=0．013,95% CI 1．17~1．85),뇌혈관병적OR치위5．42(P=0．017,95% CI 1．69~42．4)。결론리내서알치료내갑양서림금황색포도폐염적료효량호,이고PCT치、고APACHEⅡ평분화뇌혈관병시치료실패적주요위험인소。
Objective To evaluate the treatment effect of linezolid on MRSA pneumonia,and then analyze the influencing factors relevant to this treatment effect. Methods The clinical records of 47 MRSA pneumonia patients treated with linezolid admitted to our hospital from January 2009 to January 2013 were reviewed. The patients were di-vided into two groups, success group and failure group. Age, gender, weight, inflammatory indicators, APACHE Ⅱscore,arterial oxygen partial pressure and underlying diseases were comparatively analyzed,and factors influencing the treatment effect were found by logistic regression analysis. Results The rate of treatment effect was 72. 3%. The PCT value and APACHE Ⅱ score were higher[(1. 38 ± 0. 67) mg/L vs. (0. 91 ± 0. 32)mg/L,P=0. 029;14. 3 ± 5. 7 vs. 9. 8 ± 4. 1,P=0. 014),and the PaO2 was lower [(66 ± 10) mmHg vs. (72 ± 8) mmHg,P=0. 016]in the fail-ure group. PCT,APACHEⅡ score and cerebral vascular disease were factors influencing treatment effect. The OR val-ue for PCT was 2. 02(P=0. 034,95% CI 1. 06~3. 88),the OR value for APACHEⅡ was 1. 41(P=0. 013,95% CI 1. 17~1. 85),and the OR value for cerebral vascular disease was 5. 42(P=0. 017,95% CI 1. 69~42. 4). Conclusion Linezolid can effectively treat MRSA pneumonia. High PCT value,high APACHEⅡscore and cerebral vascular dis-ease are major risk factors for treatment failure.