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参附注射液联合利奈唑胺治疗耐甲氧西林金黄色葡萄球菌重症肺炎的临床观察
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| 篇名： | 参附注射液联合利奈唑胺治疗耐甲氧西林金黄色葡萄球菌重症肺炎的临床观察 |
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| 摘要： | 目的：观察参附注射液联合利奈唑胺治疗耐甲氧西林金黄色葡萄球菌（MRSA）重症肺炎患者的临床效果及安全性。方法：采用回顾性研究方法，选择2012年6月－2015年10月在我院重症监护病房治疗的62例MRSA重症肺炎患者的临床资料，按照用药方案分为观察组（25例）和对照组（28例）。在常规治疗的基础上，对照组患者给予利奈唑胺注射液600 mg，ivgtt，bid；观察组患者在对照组基础上加用参附注射液，首次静脉注射60 mL，随后以20 mL/h的速率持续静脉泵入60 mL，q12 h。两组患者均连续治疗2周。比较两组患者的临床疗效、细菌学疗效、治疗前后的心功能指标和血清炎症因子水平，以及不良反应发生情况。结果：观察组患者的临床有效率为88.00％，明显高于对照组的60.71％，差异有统计学意义（P＜0.05）。观察组患者的细菌清除率为72.00％，对照组患者为64.28％，组间比较差异无统计学意义（P＞0.05）。治疗前，两组患者的心功能指标和血清炎症因子水平比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的左室射血分数、每搏输出量、心输出量和心脏排血指数均较治疗前明显升高，血清肿瘤坏死因子α、白细胞介素6、C反应蛋白和前降钙素水平均较治疗前明显降低，且观察组上述指标水平均明显优于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗过程中均未见严重不良反应发生。结论：参附注射液联合利奈唑胺可有效改善MRSA重症肺炎患者的心功能，提高抗炎效果，临床疗效显著，且安全性较高。 |
| ABSTRACT： | OBJECTIVE： To observe clinical effect and safety of Shenfu injection combined with linezolid in the treatment of severe pneumonia caused by methicillin-resistant Staphylococcus aureus （MRSA）. METHODS： In retrospective study， 62 MRSA severe pneumonia patients selected from ICU of our hospital during Jun. 2012-Oct. 2015 were divided into observation group （25 cases） and control group （28 cases） according to medication plan. Based on routine treatment， control group was additionally given Linezolid injection 600 mg， ivgtt， bid. Observation group was additionally given Shenfu injection intravenously with initial dose of 60 mL， and then given continuous intravenous infusion of 60 mL at a rate of 20 mL/h， q12 h， on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacy， bacteriological efficacy， cardiac function indexes and serum levels of inflammatory factors before and after treatment as well as the occurrence of ADR were compared between 2 groups. RESULTS： The clinical response rate of observation group was 88.00％， which was significantly higher than 60.71％ of control group， with statistical significance （P＜0.05）. Bacterial clearance rate of observation group was 72.00％， and that of control group was 64.28％， there was no statistical significance between 2 groups （P＞0.05）. Before treatment， there was no statistical significance in cardiac function indexes and serum inflammatory factor levels between 2 groups （P＞0.05）. After treatment， LVEF， SV， CO and CI of 2 groups were increased significantly compared to before treatment， while the levels of TNF-α， IL-6， CRP and PCT were decreased significantly； the indexes of observation group was significantly better than those of control group， with statistical significance （P＜0.05）. No severe ADR was found in 2 groups. CONCLUSIONS： Shenfu injection combined with linezolid effectively improves the cardiac function of patients with MRSA severe pneumonia， enhances the anti-inflammatory effect， and have a very significant clinic effect with good safety. |
| 期刊： | 2017年第28卷第20期 |
| 作者： | 李劲松，陈继军，朱涛，巫兴阳 |
| AUTHORS： | LI Jinsong，CHEN Jijun，ZHU Tao，WU Xingyang |
| 关键字： | 耐甲氧西林金黄色葡萄球菌；重症肺炎；参附注射液；利奈唑胺；心功能；血清炎症因子 |
| KEYWORDS： | Methicillin-resistant Staphylococcus aureus； Severe pneumonia； Shenfu injection； Linezolid； Cardiac function； Serum inflammatory factor |
| 阅读数： | 284 次 |
| 本月下载数： | 2 次 |
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