比阿培南联合左氧氟沙星治疗MDR-PA致重症肺炎疗效的Meta分析  

Biapenem combined with levofloxacin in the treatment of severe pneumonia caused by MDR-PA:a Meta-analysis

作　　者：林伟 张杰 卿松 赵芳珉 Wei LIN;Jie ZHANG;Song QING;Fang-Min ZHAO(Department of Disease Prevention and Control,Air Force Hospital of Western Theater Command,PLA,Chengdu 610011,China;Department of Otolaryngology,Air Force Hospital of Western Theater Command,PLA,Chengdu 610011,China;Department of Nephrology,Air Force Hospital of Western Theater Command,PLA,Chengdu 610011,China)

机构地区：[1]西部战区空军医院疾病预防控制科,成都610011 [2]西部战区空军医院耳鼻喉科,成都610011 [3]西部战区空军医院肾内科,成都610011

出　　处：《数理医药学杂志》2023年第12期906-916,共11页Journal of Mathematical Medicine

摘　　要：目的评价比阿培南联合左氧氟沙星治疗多重耐药铜绿假单胞菌(multidrug resistant pseudomonas aeruginosa,MDR-PA)致重症肺炎的疗效,为MDR-PA致重症肺炎的治疗提供循证学依据。方法在中国知网、维普、万方、中华医学期刊全文数据库、PubMed、The Cochrane Library、Embase数据库检索相关文献,评价纳入文献的质量,采用RevMan 5.4软件进行Meta分析。结果共纳入6篇文献,包括研究对象622例,其中观察组314例、对照组308例。Meta分析结果显示观察组总有效率为93.0%,显著高于对照组的75.3%[OR=4.34,95%CI(2.62,7.19),P<0.001];观察组肺啰音消退时间[MD=-3.03,95%CI(-3.82,-2.24),P<0.001]、胸片阴影消退时间[MD=-3.42,95%CI(-3.80,-3.05),P<0.001]均短于对照组;观察组在降低白细胞计数(white blood cell count,WBC)[SMD=-1.56,95%CI(-1.79,-1.34),P<0.001]、血清降钙素原(procalcitonin,PCT)[SMD=-1.28,95%CI(-1.77,-0.79),P<0.001]、C反应蛋白(C-reactive protein,CRP)[SMD=-1.19,95%CI(-1.95,-0.44),P=0.002]方面均优于对照组。结论比阿培南联合左氧氟沙星治疗MDR-PA致重症肺炎临床疗效较好。但受纳入研究数量及质量限制,仍需要大样本、高质量的研究进一步证实。Objective To evaluate the efficacy of biapenem combined with levofloxacin in the treatment of severe pneumonia caused by multi-drug resistant pseudomonas aeruginosa(MDR-PA),and to provide evidence-based basis for the treatment of severe pneumonia caused by MDR-PA.Methods The relevant literature was searched in CNKI,VIP,WanFang Data,Chinese Medical Journal Full-Text database,PubMed,The Cochrane Library and Embase database.The quality of included articles were evaluated.RevMan 5.4 software was used for a Meta-analysis.Results A total of 6 articles including 622 subjects,314 in the observation group and 308 in the control group were included in this study.The results of Meta-analysis showed that the total effective rate of 93.0%in the observation group was significantly higher than that of 75.3%in the control group[OR=4.34,95%CI(2.62,7.19),P<0.001].The observation group had a shorter time in the disappearance of pulmonary rales[MD=-3.03,95%CI(-3.82,-2.24),P<0.001]and chest radiograph shadow resolution[MD=-3.42,95%CI(-3.80,-3.05),P<0.001]than those in the control group.The observation group was superior to the control group in reducing white blood cell count(WBC)[SMD=-1.56,95%CI(-1.79,-1.34),P<0.001],procalcitonin(PCT)[SMD=-1.28,95%CI(-1.77,-0.79),P<0.001],and C-reactive protein(CRP)[SMD=-1.19,95%CI(-1.95,-0.44),P=0.002].Conclusion The combination of biapenem and levofloxacin has shown promising clinical efficacy in the treatment of severe pneumonia caused by MDR-PA.Due to the limitation of the number and quality of included studies,large sample and high-quality studies are needed for further confirmation.

关 键 词：比阿培南 左氧氟沙星 多重耐药铜绿假单胞菌 肺炎 META分析 

分 类 号：R563.1[医药卫生—呼吸系统]