利奈唑胺对医院获得性MRSA肺炎的疗效观察  

Clinical Therapeutic Effect of Linezolid on Nosocomial Pneumonia Caused by Meticillin-resistant Staphylococcus aureus

作　　者：吴本权[1] 刘慧[1] 梁晶晶[1] 黄静[1] 周宇麒[1] 饶宪[1] 张天托[1] 

机构地区：[1]广州中山大学附属第三医院呼吸内科,广东广州510630

出　　处：《中华医院感染学杂志》2010年第22期3568-3571,共4页Chinese Journal of Nosocomiology

摘　　要：目的比较利奈唑胺与万古霉素对医院内耐甲氧西林金黄色葡萄球菌(MRSA)肺炎的疗效差异,了解利奈唑胺的临床疗效和安全性。方法收集医院2008年2月-2009年12月确诊的45例医院内MRSA肺炎应用利奈唑胺和万古霉素治疗的完整资料,记录用药前后各种临床参数包括退热时间、呼吸道症状、体征、影像学改变、肝肾功能和血常规,不良反应发生情况,比较和分析利奈唑胺与万古霉素的临床疗效的差异。结果利奈唑胺治疗组平均退热时间(3.07±1.54)d,治愈率45.0%、有效率80.0%和MRSA清除率80.0%均优于万古霉素组退热时间(8.69±3.88)d,治愈率16.0%、有效率48.0%和MRSA清除率44.0%(P<0.05);利奈唑胺组的退热率和病死率分别为87.5%和10.0%与万古霉素组的68.4%和16.0%差异无统计学意义;利奈唑胺引起腹泻2例、血小板减少4例,万古霉素致肾功能损害4例。结论利奈唑胺对医院内MRSA肺炎的临床疗效包括治愈率、有效率、退热时间和MRSA清除率均优于万古霉素;利奈唑胺的主要不良反应为腹泻和血小板减少。OBJECTIVE To investigate the therapeutic effect and safety of linezolid in the treatment of nosocomial pneumonia caused by meticillin-resistant Staphylococcus aureus （MRSA） through comparing with vancomycin. METHODS Clinical data of 45 cases of MRSA pneumonia who were treated with linezolid or vancomyein were collected and analyzed from Feb 2008 to Dec 2009, including time of pyretolysis, symptoms and signs in the respiratory tract, chest X-ray, hepatic and renal function and blood cell count. The differences of the clinical effects of linezolid and vancomycin were analyzed and compared. RESULTS Among 45 cases of MRSA pneumonia,25 were treated with vancomycin and 20 with linezolid. The average pyretolysis time, cure rate, effective rate and MRSA clearance were in order（3.07±1.54）d,45% and 80% in the linezolid group, better than that in the vancomycin group which were （8.69±3.88）d, 16%, 48.0% and 44% （P〈0. 05）. The pyretolysis rate and case fatality rate between linezolid group and vancomycin group had no statistically significance, with 87. 5M and 10. 0% in the former, 68.4% and 16.0%, in the latter （P〉0.05）. Two cases of diarrhea and four cases of thrombocytopenia were caused by linezolid, while four cases of kidney function damage caused by vancomycin. CONCLUSIONS Linezolid is better vancomycin in the cure rate, effective rate,pyretolysis interval and MRSA clearance rate. The adverse effects related with linezolid are mainly diarrhea and thrombocytopenia.

关 键 词：利奈唑胺 万古霉素 耐甲氧西林金黄色葡萄球菌 肺炎 疗效 

分 类 号：R978.1[医药卫生—药品]