国产替考拉宁与进口万古霉素治疗肾移植术后革兰阳性球菌肺部感染的评价  

Treatment of Renal Transplantation Patients with Pulmonary Infection of Gram-positive cocci:Clinical Evaluation of Domestic Teicoplanin and Imported Vancomycin

作　　者：谢续标[1] 叶明佶[1] 彭龙开[1] 彭风华[1] 蓝恭斌[1] 余少杰[1] 王彧[1] 

机构地区：[1]中南大学湘雅二医院泌外器官移植科,湖南长沙410011

出　　处：《中华医院感染学杂志》2010年第15期2296-2298,共3页Chinese Journal of Nosocomiology

摘　　要：目的比较国产替考拉宁与进口万古霉素治疗肾移植术后革兰阳性球菌肺部感染的疗效和安全性。方法 57例诊断和高度怀疑肾移植术后革兰阳性球菌肺部感染患者入选,38例应用国产替考拉宁和19例应用万古霉素治疗的患者分别设为试验组与对照组,进行治疗前后的临床症状、细菌清除情况以及不良反应的统计分析,并将临床分离培养菌分别进行国产替考拉宁和万古霉素的体外药敏试验。结果国产替考拉宁与万古霉素治疗肾移植术后革兰阳性球菌肺部感染患者的临床有效率为86.8%和84.2%,细菌清除率为91.7%和88.9%,不良反应总发生率为13.2%和26.3%,肾毒性的发生率为5.3%和15.8%,从分离到的75株病原菌药敏试验分析发现,对替考拉宁敏感率为97.3%,对万古霉素敏感率为96.0%,两组结果差异无统计学意义。结论合理的使用糖肽类抗菌药物治疗肾移植术后革兰阳性球菌肺部感染疗效强,且安全可靠,但万古霉素剂量需个体化,根据肌酐清除率调整剂量,并进行治疗药物监测(TDM)及观察肝肾功能情况;国产替考拉宁是治疗肾移植术后革兰阳性球菌肺部感染的一种安全有效的抗菌药物。OBJECTIVE To compare the efficacy and safety of domestic teicoplanin and imported vancomycin in the treatment of renal transplantion patients with lung infection of Gram-positive cocci.METHODS Diagnosis and suspicious renal transplantion in 57 cases of pulmonary infection of Gram-positive cocci were selected,38 cases with domestic teicoplanin therapy and 19 cases of imported vancomycin treatment were set to test group and control group.The therapeutic effect,clearance rate of pathogens,and side effects were compared.In vitro sensitivity test to two glycopeptide antibiotics was assayed in 75 strains of pathogens.RESULTS The clinical effective rate of domestic teicoplanin and imported vancomycin in the treatment of renal transplantion patients with lung infection of Gram-positive cocci was 86.8% and 84.2%,the bacterial clearance rate was 91.7% and 88.9%,the incidence of adverse reactions was 13.2% and 26.3%,the incidence of nephrotoxicity was 5.3% and 15.8%,from 75 isolated pathogens sensitivity test analysis found that teicoplanin was 97.3% and vancomycin was 96.0%,the results of the two groups were without significant difference.CONCLUSIONS It is high efficacy and safety so that glycopeptide antibiotics are reasonably applied in the renal transplantion patients with pulmonary infection of Gram-positive cocci,but vancomycin dosage must to be individualized,according to creatinine clearance rate to adjust and monito the therapeutic drug concentrations and liver and kidney functions;the domestic teicoplanin in the treatment of renal transplantion patients with lung infection of Gram-positive cocci is a safe and effective antibiotic.

关 键 词：替考拉宁 万古霉素 肾移植 革兰阳性球菌 肺部感染 

分 类 号：R978.1[医药卫生—药品]