利奈唑胺与万古霉素治疗耐甲氧西林金黄色葡萄球菌肺炎的对照研究  

Control study of linezolid and vancomycin in the treatment of methicillinresistant Staphylococcus aureus pneumonia

作　　者：陈国钟[1] 吴春玲[1] 滕一鸣[1] 

机构地区：[1]义乌市中心医院呼吸内科,浙江义乌322000

出　　处：《中华医院感染学杂志》2015年第7期1530-1532,共3页Chinese Journal of Nosocomiology

基　　金：国家科技支撑计划基金资助项目(2012BAI01B00)

摘　　要：目的探讨利奈唑胺与万古霉素治疗老年耐甲氧西林金黄色葡萄球菌(MRSA)肺炎的疗效,为其有效治疗提供临床依据。方法收集2009年12月-2012年12月46例MRSA肺炎老年患者的临床资料,按照治疗药物的不同分为利奈唑胺组(A组)21例和万古霉素组(B组)25例,比较两组患者的临床疗效,炎症指标的变化以及安全性,所有数据采用SPSS17.0进行统计分析。结果 MRSA肺炎老年患者治疗一疗程后有效率A组为85.71%、B组为72.00%;病原菌清除率A组为85.71%、B组为68.00%;两组患者治疗前血清中的C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平比较差异均无统计学意义;治疗一疗程后两组的CRP、TNF-α水平均较治疗前明显降低(P<0.05),且A组患者炎症指标水平下降幅度明显高于B组(P<0.05)。结论两种药物治疗老年MRSA肺炎的疗效差异性不大,但利奈唑胺整体优于万古霉素;万古霉素对患者的肾功能影响较大,考虑到老年患者的肾功能减退现状,建议老年患者使用利奈唑胺进行治疗。OBJECTIVE To study the effects of linezolid and vancomycin in the treatment of senile pneumonia infected by methicillin-resistant Staphylococcus aureus（MRSA）,so as to provide clinical evidence for the effective treatment of elderly patients with MRSA pneumonia.METHODS Clinical data of 46 senile patients with MRSA pneumonia who were admitted from 2009 Dec.to 2012 Dec.in our hospital were collected.They were divided into linezolid group（group A）with 21 cases and vancomycin group（group B）with 25 cases,according to different medication.The clinical efficacy,changes of inflammation indicators,and safety evaluation of two groups were compared.All data were analyzed by SPSS 17.0software.RESULTS After a course of treatment,the effective rate of group A was 85.71%,higher than that of 72.00% in the group B.The pathogen removal efficiency of group A was 85.71%,which was higher than that of 68.00%in the group B.Serum C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）levels showed no significant difference between the two groups of patients before treatments.After a course of treatment,CRP,TNF-αlevels of two groups were significantly lower than before（P〈0.05）,and inflammatory indicator of group A decreased remarkably than that in group B（P〈0.05）.CONCLUSIONThe curative effect of the two kinds of drugs in the treatment of elderly MRSA pneumonia is similar,but overall linezolid is better than vancomycin.Vancomycin has intense side effect on the patients renal function.Considering the reduced renal function in elderly patients,linezolid treatment was suggested to be widely used in elderly MRSA pneumonia patients.

关 键 词：耐甲氧西林金黄色葡萄球菌 肺炎 老年 利奈唑胺 万古霉素 

分 类 号：R978.1[医药卫生—药品]