不同剂量替加环素治疗多重耐药菌所致呼吸机相关性肺炎的效果及安全性  

Efficacy and safety of different doses of tigecycline on multi-drug resistant bacteria aspiration-associated pneumonia

作　　者：冯宪军[1] 赵沙沙 Feng Xianjun;Zhao Shasha(Respiratory Intensive Care Unit,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院呼吸重症监护室,河南卫辉453100

出　　处：《中国实用医刊》2021年第7期91-94,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析不同剂量替加环素治疗多重耐药菌所致呼吸机相关性肺炎的效果及安全性。方法抽取2017年1月至2020年8月新乡医学院第一附属医院收治的行不同剂量替加环素治疗的多重耐药菌所致呼吸机相关性肺炎患者68例。根据替加环素剂量不同,分为首剂量加倍组(30例)和持续高剂量组(38例)。比较两组患者的临床疗效、病菌清除效果、替加环素用药时间、住院时间、治疗前后炎性因子水平及不良反应等。结果首剂量加倍组总有效率为46.7%(14/30),低于持续高剂量组的76.3%(29/38),P<0.05。首剂量加倍组病菌清除率为33.3%(10/30),低于持续高剂量组的60.5%(23/38),P<0.05。首剂量加倍组替加环素用药时间和住院时间均长于持续高剂量组,差异有统计学意义(P<0.05)。治疗前,首剂量加倍组和持续高剂量组降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)水平比较差异未见统计学意义(P>0.05);治疗后,首剂量加倍组和持续高剂量组PCT、IL-6、TNF-α、hs-CRP水平均低于治疗前,且治疗后持续高剂量组PCT、IL-6、TNF-α、hs-CRP水平低于首剂量加倍组(P<0.05)。首剂量加倍组患者不良反应发生率(26.7%,8/30)与持续高剂量组(28.9%,11/38)比较差异未见统计学意义(P>0.05)。结论高剂量替加环素治疗多重耐药菌感染所致呼吸机相关性肺炎疗效显著,病菌清除率高,可缩短患者用药时间和住院时间,且安全有效,有利于减轻患者的炎症反应。Objective To analyze the efficacy and safety of different doses of tigecycline in the treatment of multi-drug resistant bacteria-induced ventilator-associated pneumonia.Methods Sixty-eight cases of multi-drug resistant bacteria with different doses of tigecycline were included in the First Affiliated Hospital of Xinxiang Medical University from January 2017 to August 2020.According to the doses of tigecycline,the patients were divided into two groups:the first dose double group(30 cases)and the sustained high dose group(38 cases).The clinical curative effect,bacteria clearance effect,time of tigecycline,hospitalization time,level of inflammatory factors before and after treatment and adverse reactions were compared between the two groups.Results The total effective rate was 46.7%(14/30)in the first dose double group,lower than the 76.3%(29/38)in the sustained high dose group(P<0.05).The bacterial clearance rate of the first dose double group was 33.3%(10/30),lower than the 60.5%(23/38)of the sustained high dose group(P<0.05).The administration time and hospitalization time of tigecycline in the first dose double group were longer than those in the continuous high dose group(P<0.05).Before treatment,the levels of procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)in the first dose double group and the continuous high dose group had no significant difference(P>0.05);after treatment,the levels of PCT,IL-6,TNF-α,hs-CRP in the first dose double group and the continuous high dose group were lower than those before treatment,and the levels of PCT,IL-6,TNF-α,hs-CRP in the continuous high dose group were lower than those in the first dose double group(P<0.05).There was no significant difference of the incidence of adverse reaction between the first dose double group(26.7%,8/30)and the continuous high dose group(28.9%,11/38),P>0.05.Conclusions High dose tigecycline is effective and safe in the treatment of multi-drug resistant bacterial infections with aspir

关 键 词：呼吸机相关性肺炎 替加环素 多重耐药菌 

分 类 号：R563.1[医药卫生—呼吸系统]