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替加环素治疗多重耐药鲍曼不动杆菌肺炎失败的影响因素分析
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| 篇名： | 替加环素治疗多重耐药鲍曼不动杆菌肺炎失败的影响因素分析 |
| TITLE： | Analysis of influential factors for the failure of tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii pneumonia |
| 摘要： | 目的探讨替加环素治疗多重耐药鲍曼不动杆菌（MDRAb）肺炎失败的影响因素，为合理使用替加环素提供依据。方法回顾性收集我院ICU2020年8月至2022年6月选择替加环素治疗MDRAb肺炎患者的病例资料，依据疗效将患者分为治疗失败组和治疗成功组，记录并比较两组患者的基本信息、急性生理学和慢性健康状况评价Ⅱ（APACHE-Ⅱ）评分、实验室指标、用药相关信息。采用Logistic回归分析法对替加环素治疗MDRAb肺炎失败的影响因素进行分析。结果共有102例使用替加环素治疗MDRAb肺炎的患者，其中治疗成功组有71例，治疗失败组有31例。与治疗成功组比较，治疗失败组患者APACHE-Ⅱ评分更高（P＜0.05），凝血功能异常和共病种类≥2种的例数更多（P＜0.05）。替加环素治疗后，治疗失败组降钙素原显著高于治疗成功组（P＜0.05）。Logistic回归分析显示，导致替加环素治疗MDRAb肺炎失败的独立危险因素为凝血功能异常、APACHE-Ⅱ评分≥20分（P＜0.05），首剂负荷是保护性因素（P＜0.05）。结论APACHE-Ⅱ评分≥20分和凝血功能异常的MDRAb肺炎患者，给予替加环素治疗失败的可能性大；替加环素首剂负荷给药治疗MDRAb肺炎，疗效更优。 |
| ABSTRACT： | OBJECTIVE To explore the factors influencing the failure of tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii （MDRAb） pneumonia， and to provide a basis for the rational use of tigecycline. METHODS The information of patients with MDRAb pneumonia who were treated with tigecycline in the ICU of our hospital during Aug. 2020-Jun. 2022 were collected retrospectively. The patients were divided into treatment failure group and treatment success group according to the curative effect. The basic information， acute physiology and chronic health evaluation Ⅱ （APACHE-Ⅱ） score， laboratory indicators， and medication-related information were recorded and compared between 2 groups. Logistic regression analysis was conducted for analyzing the influential factors inducing the failure of tigecycline in the treatment of MDRAb pneumonia. RESULTS A total of 102 cases of MDRAb pneumonia received tigecycline therapy， with 71 in the treatment success group and 31 in the treatment failure group. Compared with the treatment success group， the patients in the treatment failure group had higher APACHE Ⅱ score （P＜0.05）， and more cases with abnormal coagulation function and comorbidities ≥2 types （P＜0.05）. After the treatment of tigecycline， procalcitonin level of the treatment failure group was significantly higher than that of the treatment success group （P＜0.05）. Logistic regression analysis showed that the independent risk factors for the failure of tigecycline in the treatment of MDRAb pneumonia included abnormal coagulation function and APACHE-Ⅱ score ≥20 （P＜0.05）； doubling the first dose was a protective factor （P＜0.05）. CONCLUSIONS In patients with MDRAb pneumonia with APACHE-Ⅱ score ≥20 and abnormal coagulation function， tigecycline therapy is more likely to fail； doubling the first dose of tigecycline has better efficacy in the treatment of MDRAb pneumonia. |
| 期刊： | 2022年第33卷第22期 |
| 作者： | 孙国先，徐媛，刘微丽，侯红玲，尹文星 |
| AUTHORS： | SUN Guoxian，XU Yuan，LIU Weili，HOU Hongling，YIN Wenxing |
| 关键字： | 替加环素；多重耐药鲍曼不动杆菌；肺炎；治疗失败；影响因素 |
| KEYWORDS： | tigecycline； multidrug-resistant Acinetobacter baumannii； pneumonia； treatment failure； influential factor |
| 阅读数： | 222 次 |
| 本月下载数： | 10 次 |
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