莫西沙星治疗老年社区获得性肺炎的疗效及相关因素分析  

The effects of moxifloxacin and the related risk factors on community acquired pneumonia in the elderly

作　　者：李莉[1] 陈晨[1] 曾武章[1] 

机构地区：[1]建德市第一人民医院呼吸内科,浙江杭州311600

出　　处：《中国生化药物杂志》2014年第1期127-129,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的观察并比较莫西沙星和左氧氟沙星治疗老年社区获得性肺炎(community acquired pneumonia,CAP)的临床疗效,总结莫西沙星治疗失败的相关因素,提高老年CAP临床治疗质量和降低治疗费用。方法回顾性分析65例经莫西沙星和60例左氧氟沙星治疗的老年危重CAP患者的资料,评价治疗后的临床疗效和细菌学疗效,预后因素分析采用Logistic回归。结果莫西沙星组总有效率为53.85%,死亡率为16.92%,清除率为83 72%;左氧氟沙星组分别为36.67%、23.33%和70.73%,差异均具有统计学意义(P<0.05)。Logistic回归分析显示莫西沙星治疗失败的独立危险因素有年龄(OR=1.98,95%CI 1.526—2.572)、合并2种及以上慢性疾病(OR=3.671,95%CI 1.482—9.093)、水电解质紊乱(OR=2.384,95%CI 1.620-3.508)、肾功能不全(OR=2.121,95%CI 1.362—3.303)和多叶肺炎(OR=4.338,95%CI 1.468—12.819)。结论莫西沙星治疗老年危重CAP患者,其临床疗效要明显高于左氧氟沙星,但治疗失败率也较高,与多种因素有关,应对病情进行综合评估,筛选出高危患者,制定有效的的治疗策略,以改善预后。Objective To compare the effects of moxilfoxacin and levolfoxacin on community acquired pneumonia (CAP) in the elderly .Through analyzing the related failed factors of the treatment by moxilfoxacinto improving the quality of clinical treatment and reducing the costs. Method 65 cases were treated with moxilfoxacin and 60 cases were given levolfoxacin. The clinical and bacterial efifcacy were evaluated, and the related risk factors was tested by Logistc regression analysis. Resluts The clinical efifcacy rate, mortality rate and bacterial efifcacy rate were 53.85%, 16.92%and 83.72%in moxilfoxacin group, which were all signiifcantly different from 36.67%, 23.33%and 70.73%in levolfoxacin group (P<0.05). The Logistc regression analysis showed that the age (OR=1.981, 95%CI 1.526-2.572), complications≥2 (OR=3.671, 95%CI 1.482-9.093), fluid and electrolyte imbalance (OR=2.384, 95%CI 1.620-3.508), renal insufifciency (OR=2.121, 95%CI 1.362-3.303) and leafy pneumonia (OR=4.338, 95%CI 1.468-12.819) were independent risk factors for treatment failure. Conlusion The clinical curative effect in elderly patients with severe CAP treated by moxilfoxacin is signiifcantly higher than levolfoxacin. But treatment failure rate is also higher. The result relates to a variety of factors. We should cope with CAP by a comprehensive evaluation to screen high-risk patients, in order to make an effective treatment strategy and improve the prognosis.

关 键 词：社区获得性肺炎 莫西沙星 左氧氟沙星 预后 

分 类 号：R515[医药卫生—内科学] R518.9[医药卫生—临床医学]