中国临床药理学杂志
中國臨床藥理學雜誌
중국림상약이학잡지
The Chinese Journal of Clinical Pharmacology
2015年
15期
1477-1479
,共3页
老年患者%呼吸机相关性肺炎%利奈唑胺%万古霉素%疗效
老年患者%呼吸機相關性肺炎%利奈唑胺%萬古黴素%療效
노년환자%호흡궤상관성폐염%리내서알%만고매소%료효
elderly patients%ventilator associated pneumonia%linezolid%vancomycin%efficacy
目的：评价利奈唑胺与万古霉素治疗老年呼吸机相关性肺炎（ VAP）的疗效及安全性。方法入选76例耐甲氧西林金黄色葡萄球菌（ MRSA）老年VAP患者，随机分为万古霉素组37例（对照组）与利奈唑胺组39例（试验组）。对照组静脉滴注万古霉素1.0 g，每日2次，共7 d；试验组静脉滴注利奈唑胺600 mg，每日2次，共7d。比较2组临床疗效，病原菌清除率，治疗疗程，治疗前后相关炎症指标水平变化情况及不良反应发生率。结果治疗后，对照组临床总有效率为78.38％，显著低于试验组的94.87％（ P＜0.05）。对照组病原菌清除率为59.46％，显著低于试验组的87.18％（ P ＜0.05）。对照组治疗疗程为（17.27±3.33）d，显著高于试验组的（13.02±3.07）d（P＜0.05）。2组治疗后白细胞、C反应蛋白及降钙素原水平变化均显著低于治疗前，且试验组治疗后上述指标显著高于对照组（P＜0.05）。对照组不良反应发生率为10.81％，试验组为10.26％，差异无统计学意义（ P＞0.05）。结论利奈唑胺治疗MRSA老年VAP的疗效显著优于万古霉素，不良反应发生率无差异。
目的：評價利奈唑胺與萬古黴素治療老年呼吸機相關性肺炎（ VAP）的療效及安全性。方法入選76例耐甲氧西林金黃色葡萄毬菌（ MRSA）老年VAP患者，隨機分為萬古黴素組37例（對照組）與利奈唑胺組39例（試驗組）。對照組靜脈滴註萬古黴素1.0 g，每日2次，共7 d；試驗組靜脈滴註利奈唑胺600 mg，每日2次，共7d。比較2組臨床療效，病原菌清除率，治療療程，治療前後相關炎癥指標水平變化情況及不良反應髮生率。結果治療後，對照組臨床總有效率為78.38％，顯著低于試驗組的94.87％（ P＜0.05）。對照組病原菌清除率為59.46％，顯著低于試驗組的87.18％（ P ＜0.05）。對照組治療療程為（17.27±3.33）d，顯著高于試驗組的（13.02±3.07）d（P＜0.05）。2組治療後白細胞、C反應蛋白及降鈣素原水平變化均顯著低于治療前，且試驗組治療後上述指標顯著高于對照組（P＜0.05）。對照組不良反應髮生率為10.81％，試驗組為10.26％，差異無統計學意義（ P＞0.05）。結論利奈唑胺治療MRSA老年VAP的療效顯著優于萬古黴素，不良反應髮生率無差異。
목적：평개리내서알여만고매소치료노년호흡궤상관성폐염（ VAP）적료효급안전성。방법입선76례내갑양서림금황색포도구균（ MRSA）노년VAP환자，수궤분위만고매소조37례（대조조）여리내서알조39례（시험조）。대조조정맥적주만고매소1.0 g，매일2차，공7 d；시험조정맥적주리내서알600 mg，매일2차，공7d。비교2조림상료효，병원균청제솔，치료료정，치료전후상관염증지표수평변화정황급불량반응발생솔。결과치료후，대조조림상총유효솔위78.38％，현저저우시험조적94.87％（ P＜0.05）。대조조병원균청제솔위59.46％，현저저우시험조적87.18％（ P ＜0.05）。대조조치료료정위（17.27±3.33）d，현저고우시험조적（13.02±3.07）d（P＜0.05）。2조치료후백세포、C반응단백급강개소원수평변화균현저저우치료전，차시험조치료후상술지표현저고우대조조（P＜0.05）。대조조불량반응발생솔위10.81％，시험조위10.26％，차이무통계학의의（ P＞0.05）。결론리내서알치료MRSA노년VAP적료효현저우우만고매소，불량반응발생솔무차이。
Objective To investigate the efficacy and safety of linezolid and vancomycin in the treatment of ventilator associated pneumonia in elderly patients.Methods A total of 76 patients with methicillin-resistant Staphylococcus aureus ( MRSA ) related ventilator associated pneumonia were recruited in our hospital.The 76 patients were randomly divided into control group ( n=37 ) and trial group ( n =39 ).Patients in the control group were given vancomycin 1.0 g bid by intravenous drop infu-sion for 7 days and patients in the treatment group were given linezolid 600 mg bid by intravenous drop infusion for 7 days.After treatment, the data of clinical efficacy, pathogen clearance, treatment course, inflammatory factors and adverse reactions were compared between the two groups.Results The clinical efficacy of trial group was statistically higher than that of control group (94.87%vs 78.38%, P<0.05).The pathogen clearance of trial group was statistically higher than that of control group( 87.18%vs 59.46%, P<0.05).The treatment course of trial group was statistically shorter than that of control group [(13.02 ±3.07) vs (717.27 ±3.33)d, P<0.05)].The inflammatory factors ( WBC, PLT, CRP and PCT ) were significantly decreased after treatment in both groups ( P<0.05 ).The incidence rate of adverse reactions in the two groups were not statistically different ( P >0.05 ).Conclusion Linezolid is superior to vancomycin in the treatment of ventilator associated pneumonia in elderly patients, without significant difference in adverse reactions.
