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国产和进口万古霉素治疗神经外科术后肺部感染MRSA的回顾性配对研究
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| 篇名： | 国产和进口万古霉素治疗神经外科术后肺部感染MRSA的回顾性配对研究 |
| TITLE： | |
| 摘要： | 目的：比较国产和进口万古霉素治疗神经外科术后肺部感染耐甲氧西林金黄色葡萄球菌（MRSA）的疗效和安全性。方法：将2014年1月－2015年6月在我院诊断为MRSA肺部感染且使用国产万古霉素的神经外科术后患者作为国产万古霉素组，将2015年7月－2018年12月使用进口万古霉素者作为进口万古霉素组，应用倾向性评分的方法按1 ∶ 1匹配两组基线数据，比较两组患者的30 d全因死亡率、重症患者90 d全因死亡率、7 d细菌有效清除率以及药品不良反应发生率。结果：国产万古霉素组共纳入108例患者，进口万古霉素组纳入279例患者，进行倾向性评分匹配后最终两组均纳入108例患者。国产和进口万古霉素组患者的30 d全因死亡率分别为10.19％（11/108）、7.41％（8/108），22对重症患者90 d全因死亡率均为63.64％，7 d细菌有效清除率分别为75.00％（48/64）和81.94％（59/72），组间比较差异均无统计学意义（P＞0.05）。国产组和进口组的血肌酐升高＞1倍的发生率分别为25.93％（28/108）和12.04％（13/108），总不良反应发生率分别为29.63％（32/108）和15.74％（17/108），组间比较差异均有统计学意义（P＜0.05）。结论：对于神经外科术后肺部感染MRSA的患者，使用进口和国产万古霉素疗效相当，但临床需密切关注其安全性，尤其是血肌酐升高问题。 |
| ABSTRACT： | OBJECTIVE： To compare the efficacy and safety of domestic vancomycin and imported vancomycin in the treatment of methicillin-resistant Staphylococcus aureus （MRSA） caused lung infection after neurosurgery. METHODS： The patients after neurosurgery with MRSA pulmonary infection diagnosed in our hospital from Jan. 2014 to Jun. 2015 and using domestic vancomycin were included in domestic vancomycin group， while those who used imported vancomycin from Jul. 2015 to Dec. 2018 were included in imported vancomycin group. The baseline data of the two groups were matched by 1 ∶ 1 according to propensity score matching method. The 30-day all-cause mortality， 90-day all-cause mortality of severe patients， 7 d effective bacterial clearance rate and the incidence of ADR were compared between 2 groups. RESULTS： There were 108 cases in domestic vancomycin group and 279 cases in imported vancomycin group. After propensity score matching， 108 cases in domestic and 108 cases in imported vancomycin group were finally included. The 30-day mortality rates of domestic group and imported group were 10.19％（11/108） and 7.41％（8/108） respectively， and the 90-day all-cause mortality of 22 pairs of severe patients were 63.64％. The 7 d effective bacterial clearance rates were 75.00％（48/64） and 81.94％（59/72）， and there was no statistical significance （P＞0.05）. The incidences of creatinine increase ＞1 fold were 25.93％（28/108） and 12.04％（13/108）， the total incidences of ADR were 29.63％（32/108） and 15.74％（17/108）， respectively， with statistical significance （P＜0.05）. CONCLUSIONS： The therapeutic efficacy of imported vancomycin is similar to that of domestic vancomycin in the treatment of postoperative pulmonary infection with MRSA after neurosurgery， but the safety needs to pay close attation， especially the rise of serum creatinime. |
| 期刊： | 2019年第30卷第18期 |
| 作者： | 何效平，荣秋玲，何梅，刘福 |
| AUTHORS： | HE Xiaoping，RONG Qiuling，HE Mei，LIU Fu |
| 关键字： | 万古霉素；耐甲氧西林金黄色葡萄球菌；肺部感染；神经外科；术后；国产；进口；倾向性评分匹配法 |
| KEYWORDS： | Vancomycin； Methicillin-resistant Staphylococcus aureus； Lung infection； Neurosurgery； Postoperation； Domestic； Imported；Propensity matching method |
| 阅读数： | 455 次 |
| 本月下载数： | 10 次 |
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