军团菌抗体阳性重症肺炎患者的临床特征及用药情况  

Clinical characteristics and medication of severe pneumonia patients with Legionella antibody positive

作　　者：高亚敏[1] 师艳艳[1] 曾聪慧 徐鹏丽 邹小广[1] GAO Yamin;SHI Yanyan;ZENG Conghui;XU Pengli;ZOU Xiaoguang(Department of Pharmacy,the First People's Hospital of Kashi,Xinjiang Uygur Autonomous Region,Kashi844000,China)

机构地区：[1]新疆维吾尔自治区喀什地区第一人民医院药学部,新疆喀什844000

出　　处：《中国当代医药》2023年第2期144-147,共4页China Modern Medicine

基　　金：新疆维吾尔自治区药学会科研基金资助项目(YXH201901)。

摘　　要：目的探讨重症监护病房(ICU)军团菌抗体阳性重症肺炎患者的临床特征及用药情况。方法回顾性选取2020年1月至2021年2月于喀什地区第一人民医院呼吸ICU、外科ICU、创伤ICU、急诊ICU、综合ICU的70例军团菌抗体阳性重症肺炎患者作为观察组,选取同期100例军团菌抗体阴性重症肺炎患者作为对照组。比较两组患者临床特征、实验室检查、影像特征及抗菌药物使用量的差异。结果两组患者的体重指数、体温、中性粒细胞百分比、谷氨酸氨基转移酶、直接胆红素、血肌酐、尿素氮比较,差异无统计学意义(P>0.05);观察组的白细胞计数、丙氨酸氨基转移酶、总胆红素低于对照组,差异有统计学意义(P<0.05)。观察组伴有胸腔积液比例低于对照组,差异有统计学意义(P<0.05);两组患者的其他胸部CT征象比较,差异无统计学意义(P>0.05)。两组患者在ICU住院期间的病死率比较,差异无统计学意义(P>0.05)。两组患者的阿奇霉素抗菌药物使用强度(DDDs)比较,差异无统计学意义(P>0.05),观察组的莫西沙星和左氧氟沙星DDDs高于对照组,差异有统计学意义(P<0.05)。结论ICU军团菌抗体阳性重症肺炎患者其临床表现与普通重症肺炎患者并无明显差异,在治疗中加用一种抗菌药物覆盖军团菌,患者预后并未出现明显改善。Objective To investigate the clinical characteristics and medication of severe pneumonia patients with Legionella antibody positive in intensive care unit(ICU).Methods Seventy patients with severe pneumonia with Legionella antibody positive in respiratory ICU,surgical ICU,trauma ICU,emergency ICU and comprehensive ICU of the First People's Hospital of Kashi from January 2020 to February 2021 were selected retrospectively as the observation group,100 severe pneumonia patients with negative Legionella antibody were selected as the control group,compare the differences in clinical characteristics,laboratory examination,imaging examination and usage of antimicrobial agents between the two groups.Results There were no significant differences in body mass index,body temperature,neutrophil percentage,glutamate aminotransferase,direct bilirubin,serum creatinine and urea nitrogen between two groups(P>0.05).The white blood cell count,alanine aminotransferase and total bilirubin of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The proportion of pleural effusion in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There were no statistical significances in other chest CT signs between the two groups(P>0.05).There was no significant difference in mortality during ICU stay between the two groups(P>0.05).There was no statistical significance in Azithromycin antimicrobial defined daily dose(DDDs)between the two groups(P>0.05),while the DDDs of Moxifloxacin and Levofloxacin in the observation group were higher than those in the control group,with statistical significances(P<0.05).Conclusion The clinical manifestations of ICU patients with Legionella antibody positive severe pneumonia are not significantly different from those of ordinary patients with severe pneumonia.The prognosis of patients with legionella antibody positive severe pneumonia is not significantly improved by adding an an

关 键 词：重症监护病房 军团菌 重症肺炎 抗菌药物 

分 类 号：R969.3[医药卫生—药理学]