CAJ | 학술논문

目的：探讨万古霉素治疗耐甲氧西林金黄色葡萄球菌（M RS A ）肺炎老年患者的疗效和安全性。方法回顾性分析M RS A肺炎老年患者40例，根据治疗方案，将患者分为2组：万古霉素组25例，给予万古霉素每次0．5 g ，每8小时1次，静脉滴注，治疗时间10～14 d；利奈唑胺组15例，给予利奈唑胺每次0．6 g ，每12小时1次，静脉滴注，治疗时间10～14 d。比较两组患者的疗效和不良反应。结果万古霉素组临床有效率为72．0％，利奈唑胺组为86．7％，两组比较差异无统计学意义（P＞0．05）；经治疗后，万古霉素组MRSA清除率为76．0％，利奈唑胺组为80．0％，两组比较差异无统计学意义（P＞0．05）；利奈唑胺组有3例发生血小板减少＞25％，占20．0％，万古霉素组未见血小板减少，万古霉素组有4例发生急性肾功能不全，占16．0％，利奈唑胺组未见肾功能损害。结论万古霉素治疗老年M RS A肺炎有较好的临床疗效，血小板减少的发生率低，应警惕急性肾功能不全的风险。
목적：탐토만고매소치료내갑양서림금황색포도구균（M RS A ）폐염노년환자적료효화안전성。방법회고성분석M RS A폐염노년환자40례，근거치료방안，장환자분위2조：만고매소조25례，급여만고매소매차0．5 g ，매8소시1차，정맥적주，치료시간10～14 d；리내서알조15례，급여리내서알매차0．6 g ，매12소시1차，정맥적주，치료시간10～14 d。비교량조환자적료효화불량반응。결과만고매소조림상유효솔위72．0％，리내서알조위86．7％，량조비교차이무통계학의의（P＞0．05）；경치료후，만고매소조MRSA청제솔위76．0％，리내서알조위80．0％，량조비교차이무통계학의의（P＞0．05）；리내서알조유3례발생혈소판감소＞25％，점20．0％，만고매소조미견혈소판감소，만고매소조유4례발생급성신공능불전，점16．0％，리내서알조미견신공능손해。결론만고매소치료노년M RS A폐염유교호적림상료효，혈소판감소적발생솔저，응경척급성신공능불전적풍험。
Objective To examine the efficacy and safety profile of vancomycin in treatment of pneumonia caused by methicillin‐resistant Staphylococcus aureus (MRSA)in the elderly patients .Methods The clinical data were retrospectively analyzed for 40 elderly patients with MRSA‐induced pneumonia .The patients were analyzed in terms of treatment regimen ,vancomycin (n=25)or linezolid (n= 15) .Vancomycin was administered intravenously at dose of 0 .5 g every 8 hours for 10‐14 days ,while linezolid was given intravenously at dose of 0 .6 g every 12 hours for 10‐14 days .The clinical efficacy and adverse events were compared between the two groups .Results The overall efficacy rate was 72 .0% in vancomycin group ,and 86 .7% in linezolid group (P>0 .05) .After treatment ,the clearance rate of MRSA was 76 .0% in vancomycin group ,and 80 .0% in linezolid group (P>0 .05) .Reduction of platelet counts by more than 25% was found in 3 (20 .0% )patients treated with linezolid ,but none patient in vancomycin group .Acute renal dysfunction was reported in 4 (16 .0% )patients in vancomycin group but not identified in linezolid group .Conclusions Vancomycin has positive effect in the treatment of MRSA pneumonia in the elderly . Vancomycin treatment is associated with lower risk of thrombocytopenia ,but relatively higher risk of acute renal dysfunction .