美罗培南注射剂联合头咆哌酮钠舒巴坦钠注射剂治疗脓毒症休克合并肾功能不全的临床研究  

Clinical trial of meropenem injection combined with sulbactam and cefopcrazone injection in the treatment of septic shock complicated with renal insufficiency

作　　者：李俊伟[1] 孙洁[1] LI Jun-wei;SUN Jie(Department of Intensive - Care Unit,The Second People’s Hospital of YunnanProvince, Kunming 650021, YunnanProvince,China)

机构地区：[1]云南省第二人民医院重症医学科

出　　处：《中国临床药理学杂志》2019年第15期1574-1577,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察美罗培南注射剂联合头咆哌酮钠舒巴坦钠注射剂治疗脓毒症休克合并肾功能不全的临床疗效与安全性。方法将84例脓毒症休克合并肾功能不全患者随机分为对照组和试验组,每组42例。对照组予以头孢哌酮钠舒巴坦钠每次2 g,qd,静脉注射;试验组在对照组治疗的基础上,予以美罗培南每次3 g,qd,微量注射泵持续泵入。2组患者均治疗14 d。比较2组患者的临床疗效,白细胞介素-6(IL-6)、IL-8、C反应蛋白(CRP)和肾功能,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为95. 23%(40例/42例)和69. 05%(29例/42例),差异有统计学意义(P <0. 05)。治疗后,试验组和对照组的IL-6分别为(104. 93±11. 88)和(148. 13±26. 54)ng·L^-1,IL-8分别为(104. 43±12. 69)和(138. 43±19. 79) ng·L^-1,CRP分别为(4. 33±0. 58)和(9. 83±1. 10) mg·L^-1,血清肌酸酐分别为(74. 21±9. 24)和(97. 82±12. 42)μmol·L^-1,血尿素氮分别为(7. 28±0. 71)和(9. 73±1. 17)mmol·L^-1,差异均有统计学意义(均P <0. 05)。试验组的药物不良反应主要有皮疹和恶心呕吐,对照组的药物不良反应主要有皮疹和腹泻。试验组和对照组的总药物不良反应发生率分别为9. 52%和7. 14%,差异无统计学意义(P> 0. 05)。结论美罗培南注射剂联合头咆哌酮钠舒巴坦钠注射剂治疗脓毒症休克合并肾功能不全的临床疗效确切,其能显著地降低炎症因子水平,改善肾功能,且不增加药物不良反应的发生率。Objective To observe the clinical efficacy and safety of meropenem injection combined with sulbactam and cefopcrazone injection in the treatment of septic shock complicated with renal insufficiency. Methods A total of 84 patients with septic shock complicated with renal insufficiency were randomly divided into control and treatment groups with 42 cases per group. Control group received sulbactam and cefoperazone 2 g per time,qd,intravenous injection. Treatment group was given meropenem 3 g per time,qd,continuous pumping of microinjection pump,on the basis of control group. Two groups were treated for 14 days. The clinical efficacy,interleukin - 6 ( IL - 6 ),IL - 8,C - reactive protein ( CRP) and renal function indexes,and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 95. 23%( 40 cases / 42 cases ) and 69. 05%( 29 cases / 42 cases ) with significant difference ( P < 0. 05). After treatment,the main indexes of treatment and control groups were compared: IL - 6 were ( 104. 93 ± 11. 88) and ( 148. 13 ± 26. 54) ng·L^-1,IL - 8 were( 104. 43 ± 12. 69) and ( 138. 43 ± 19. 79) ng·L^-1, CRP were ( 4. 33 ± 0. 58) and ( 9. 83 ± 1. 10) mg·L^-1,serum creatinine were ( 74. 21 ± 9. 24) and ( 97. 82 ± 12. 42)μmol·L^-1,blood urea nitrogen were ( 7. 28 ± 0. 71) and ( 9. 73 ± 1. 17) mmol·L^-1,the differences were statistically significant ( all P < 0. 05). The adverse drug reactions of treatment group were rash and nausea and vomiting,which in control group were rash and diarrhea. The total incidences of adverse drug reactions in treatment and control groups were 9. 52% and 7. 14% without significant difference ( P > 0. 05). Conclusion Meropenem injection combined with sulbactam and cefopcrazone injection has a definitive clinical efficacy in the treatment of septic shock complicated with renal insufficiency,which can significantly reduce the level of inflammatory cytokines and improve renal function, without increasing

关 键 词：美罗培南注射剂 头咆哌酮钠舒巴坦钠注射剂 脓毒症休克 肾功能不全 安全性评价 

分 类 号：R978.1[医药卫生—药品]