CAJ | 학술논문

目的：探讨利奈唑胺与万古霉素治疗老年耐甲氧西林金黄色葡萄球菌（M RS A ）肺炎的疗效，为其有效治疗提供临床依据。方法收集2009年12月－2012年12月46例M RS A肺炎老年患者的临床资料，按照治疗药物的不同分为利奈唑胺组（A组）21例和万古霉素组（B组）25例，比较两组患者的临床疗效，炎症指标的变化以及安全性，所有数据采用SPSS17．0进行统计分析。结果 M RSA 肺炎老年患者治疗一疗程后有效率 A组为85．71％、B组为72．00％；病原菌清除率A组为85．71％、B组为68．00％；两组患者治疗前血清中的C‐反应蛋白（CRP）、肿瘤坏死因子‐α（TNF‐α）水平比较差异均无统计学意义；治疗一疗程后两组的CRP、TNF‐α水平均较治疗前明显降低（P＜0．05），且A组患者炎症指标水平下降幅度明显高于B组（P＜0．05）。结论两种药物治疗老年M RS A肺炎的疗效差异性不大，但利奈唑胺整体优于万古霉素；万古霉素对患者的肾功能影响较大，考虑到老年患者的肾功能减退现状，建议老年患者使用利奈唑胺进行治疗。
목적：탐토리내서알여만고매소치료노년내갑양서림금황색포도구균（M RS A ）폐염적료효，위기유효치료제공림상의거。방법수집2009년12월－2012년12월46례M RS A폐염노년환자적림상자료，안조치료약물적불동분위리내서알조（A조）21례화만고매소조（B조）25례，비교량조환자적림상료효，염증지표적변화이급안전성，소유수거채용SPSS17．0진행통계분석。결과 M RSA 폐염노년환자치료일료정후유효솔 A조위85．71％、B조위72．00％；병원균청제솔A조위85．71％、B조위68．00％；량조환자치료전혈청중적C‐반응단백（CRP）、종류배사인자‐α（TNF‐α）수평비교차이균무통계학의의；치료일료정후량조적CRP、TNF‐α수평균교치료전명현강저（P＜0．05），차A조환자염증지표수평하강폭도명현고우B조（P＜0．05）。결론량충약물치료노년M RS A폐염적료효차이성불대，단리내서알정체우우만고매소；만고매소대환자적신공능영향교대，고필도노년환자적신공능감퇴현상，건의노년환자사용리내서알진행치료。
OBJECTIVE To study the effects of linezolid and vancomycin in the treatment of senile pneumonia infec‐ted by methicillin‐resistant Staphylococcus aureus (MRSA) ,so as to provide clinical evidence for the effective treatment of elderly patients with MRSA pneumonia .METHODS Clinical data of 46 senile patients with MRSA pneumonia who were admitted from 2009 Dec .to 2012 Dec .in our hospital were collected .They were divided into linezolid group (group A) with 21 cases and vancomycin group (group B) with 25 cases ,according to different medication .The clinical efficacy ,changes of inflammation indicators ,and safety evaluation of two groups were compared .All data were analyzed by SPSS 17 .0 software .RESULTS After a course of treatment ,the effective rate of group A was 85 .71% ,higher than that of 72 .00% in the group B .The pathogen removal efficiency of group A was 85 .71% ,which was higher than that of 68 .00% in the group B .Serum C‐reactive protein (CRP) , tumor necrosis factor‐α (TNF‐α) levels showed no significant difference between the two groups of patients before treatments .After a course of treatment ,CRP ,TNF‐α levels of two groups were significantly lower than before (P<0 .05) ,and inflammatory indicator of group A decreased remarkably than that in group B (P< 0 .05) . CONCLUSION The curative effect of the two kinds of drugs in the treatment of elderly MRSA pneumonia is simi‐lar ,but overall linezolid is better than vancomycin .Vancomycin has intense side effect on the patients renal func‐tion .Considering the reduced renal function in elderly patients ,linezolid treatment was suggested to be widely used in elderly M RSA pneumonia patients .