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利奈唑胺联合替考拉宁治疗耐甲氧西林金黄色葡萄球菌性重症肺炎的临床观察
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| 篇名： | 利奈唑胺联合替考拉宁治疗耐甲氧西林金黄色葡萄球菌性重症肺炎的临床观察 |
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| 摘要： | 目的：观察利奈唑胺联合替考拉宁治疗耐甲氧西林金黄色葡萄球菌（MRSA）性重症肺炎的临床疗效及安全性。方法：选取MRSA性重症肺炎患者150例，按随机数字表法分为联合组、利奈唑胺组和替考拉宁组，各50例。利奈唑胺组患者给予利奈唑胺注射液600 mg，ivgtt，bid；替考拉宁组患给予注射用替考拉宁400 mg，ivgtt，bid；联合组患者首先给予同等用法用量的利奈唑胺注射液，持续1周，然后给予同等用法用量的替考拉宁注射液，持续1周。3组患者均治疗2周。观察3组患者临床有效率、细菌总清除率及治疗前后血清炎症因子水平[C反应蛋白（CRP）、降钙素原（PCT）、肿瘤坏死因子α（TNF-α）]和白细胞计数，并比较不良反应发生情况。结果：联合组患者临床有效率为90.0％，细菌总清除率为86.0％，利奈唑胺组临床有效率为84.0％，细菌总清除率为80.0％，均显著高于替考拉宁组（70.0％和64.0％），差异均有统计学意义（P＜0.05）。治疗前，3组患者血清炎症因子水平和白细胞计数比较，差异无统计学意义（P＞005）；治疗后，3组患者CRP、PCT、TNF-α和白细胞水平均显著降低，且联合组和利奈唑胺组明显低于替考拉宁组，差异均有统计学意义（P＜0.05）。联合组与利奈唑胺组患者临床疗效、细菌总清除率及治疗后炎性因子、白细胞计数比较，差异均无统计学意义（P＞0.05）。联合组患者不良反应发生率明显低于利奈唑胺组和替考拉宁组，差异有统计学意义（P＜0.05）。结论：利奈唑胺联合替考拉宁治疗MRSA性重症肺炎与单用利奈唑胺疗效相当，均能明显改善血清炎性因子水平及白细胞计数，且联合组和利奈唑胺组明显优于替考拉宁组，但联合组患者不良反应发生率低，安全性较高。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of linezolid combined with teicoplanin in the treatment of severe methicillin-resistant Staphylococcus aureus （MRSA） pneumonia. METHODS： 150 patients diagnosed as severe MRSA pneumonia were collected and divided into combination group， linezolid group and teicoplanin group， with 50 cases in each group occording to random number table. Linezolid group received Linezolid injection 600 mg， ivgtt， bid； teicoplanin group received Teicoplanin for injection 400 mg， ivgtt， bid； combination group received Linezolid injection with same usage and dosage， for 1 week， and then received Teicoplanin injection with same usage and dosage， for 1 week. All 3 groups received treatment for 2 weeks. The clinical effective rate， effective bacterial clearance rate， serum levels of serum inflammatory factors [CRP， PCT， TNF-α] and leucocyte count were observed in 3 groups， and the occurrence of ADR were compared among 3 groups. RESULTS： The clinical effective rates of combination group and linezolid group were 90.0％ and 84.0％， and effective bacterial clearance rates were 86.0％ and 80.0％， which were significantly higher than those of teicoplanin group （70.0％ and 64.0％）， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in serum inflammatory factors and leucocyte count among 3 groups （P＞0.05）. After treatment， the levels of CRP， PCT， TNF-α and leukocyte in 3 groups were decreased significantly， and the combination group and linezolid group were significantly lower than the teicoplanin group， with statistical significance （P＜0.05）. The incidence of ADR in combination group were significantly lower than in linezolid group and teicoplanin group， with statistical significance （P＜0.05）. CONCLUSIONS： Linezolid combined with teicoplanin is similar to linezolid alone in the treatment of severe MRSA pneumonia. Both can improve the levels of serum inflammatory factors and leucocyte count， and combination group and linezolid group were superior to teicoplanin group， while patients in combination group show low incidence of adverse reactions， with higher safety. |
| 期刊： | 2016年第27卷第32期 |
| 作者： | 杜中良，焦玉坤，程振田，牛义凯 |
| AUTHORS： | DU Zhongliang，JIAO Yukun，CHENG Zhentian，NIU Yikai |
| 关键字： | 利奈唑胺；替考拉宁；重症肺炎；耐甲氧西林金黄色葡萄球菌；疗效；炎症因子 |
| KEYWORDS： | Linezolid； Teicoplanin； Severe pneumonia； Methicillin-resistant Staphylococcus aureus； Clinical efficacy； Inflammatory factor |
| 阅读数： | 485 次 |
| 本月下载数： | 4 次 |
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