多黏菌素B雾化吸入在治疗MDROs引起的呼吸机相关肺炎中的疗效与安全性分析  

Analysis of the efficacy and safety of aerosolized polymyxin B in the treatment of MDROs-induced ventilator-associated pneumonia

作　　者：李书锐 王日兴[1] 李诗阳[1] LI Shurui;WANG Rixing;LI Shiyang(Department of Emergency,the Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570311,China)

机构地区：[1]海南医学院第二附属医院急诊科,海南海口570311

出　　处：《徐州医科大学学报》2020年第4期261-264,共4页Journal of Xuzhou Medical University

基　　金：海南省卫生厅科研课题项目(1801032061A2006)。

摘　　要：目的探讨多黏菌素B雾化吸入治疗多重耐药菌(MDROs)引起的呼吸机相关肺炎(VAP)的疗效与安全性。方法采用头对头比较,分析多黏菌素E雾化吸入组(A组)、多黏菌素E静脉治疗组(B组)和多黏菌素B雾化吸入组(C组)治疗MDROs引起的VAP的效果和安全性。结果多黏菌素B雾化吸入治疗有效率为76.7%,优于多黏菌素E雾化吸入和多黏菌素E静脉滴注,差异有统计学意义(P<0.05),治疗达到显效的平均时间为(7.3±2.1)d。多黏菌素B雾化吸入后,患者血清降钙素原(PCT)、前白蛋白(PA)和肿瘤坏死因子(TNF-0x0E?SymbolaA@0x0F)明显优于多黏菌素E雾化吸入和多黏菌素E静脉滴注患者,CD4+、CD4+/CD8+明显优于多黏菌素E雾化吸入和多黏菌素E静脉滴注患者,差异有统计学意义(P<0.05)。多黏菌素B雾化治疗安全性良好,未见严重不良反应。结论多黏菌素B雾化吸入比多黏菌素E雾化吸入、多黏菌素E静脉给药治疗MDROs引起的VAP的效果更佳,安全性相当,具有显著的临床价值。Objective To investigate the efficacy and safety of aerosol inhalation of polymyxin B in the treatment of ventilator-associated pneumonia(VAP)caused by multiple drug resistance organisms(MDROs).Methods Head-to-head comparison was conducted to investigate the efficacy and safety of aerosol inhalation of polymyxin E(group A),intravenous injection of polymyxin E(group B),and aerosol inhalation of polymyxin B(group C)in the treatment of VAP caused by MDROs.Results Aerosol inhalation of polymyxin B had an effective rate of 76.7%,which was significantly better than aerosol inhalation of polymyxin E and intravenous infusion of polymyxin E(P<0.05).The average effective treatment time was(7.3±2.1)days.After aerosol inhalation of polymyxin B,the patients presented remarkably increased levels of serum prealbumin(PA),procalcitonin(PCT),and tumor necrosis factor(TNF-α),as well as CD4+and CD4+/CD8+,compared with those receiving aerosolized polymyxin E and intravenously infused with polymyxin E(P<0.05).Aerosol inhalation of polymyxin B had good safety,without severe adverse reactions.Conclusions Aerosol inhalation of polymyxin B is more effective than intravenous injection of polymyxin E and aerosol inhalation of polymyxin E in the treatment of VAP caused by MDROs.The safety is comparable and has significant clinical value.

关 键 词：多黏菌素B 多药耐药 呼吸机相关肺炎 

分 类 号：R453.2[医药卫生—治疗学]