利奈唑胺不同用药方案治疗老年重症耐甲氧西林金黄色葡萄球菌肺炎的疗效和经济学分析  

The efficacy and economic analysis of linezolid with different medication regimens on methicillin-resistant Staphylococcus aureus severe pneumonia in elderly patients

作　　者：张丽娜 方彩霞 邢晓娟 冲刘军 脱鸣富 ZHANG Li'na;FANG Caixia;XING Xiaojuan;CHONG Liujun;TUO Mingfu(People's Hospital of Qingyang City,Qingyang,Gansu,745100,China;Affiliated Hospital of Gansu Medical College,Pingliang,Gansu,337000,China)

机构地区：[1]庆阳市人民医院,甘肃庆阳745000 [2]甘肃医学院附属医院,甘肃平凉337000

出　　处：《当代医学》2024年第7期10-15,共6页Contemporary Medicine

摘　　要：目的探讨利奈唑胺不同用药方案治疗老年重症耐甲氧西林金黄色葡萄球菌(MRSA)肺炎的疗效和经济学。方法选取2018年5月至2020年12月于庆阳市人民医院呼吸内科及重症医学科确诊的120例老年重症MRSA肺炎患者作为研究对象,按照随机数字表法分为对照组与实验组,每组60例。对照组予以利奈唑胺600 mg,每12 h静脉滴注1次;实验组每天上午9:00予以利奈唑胺600 mg静脉滴注,晚上9:00予以利奈唑胺片600mg口服。比较两组临床疗效、细菌清除率、不良反应发生情况及药物经济学。结果两组治疗总有效率和细菌清除总有效率比较差异无统计学意义。实验组治疗后血小板计数低于对照组,差异有统计学意义(P<0.05);两组血小板减少症发生率比较差异无统计学意义。两组床位费、检查费、护理费、治疗费、其他药物费用比较差异无统计学意义;实验组利奈唑胺费用、处理不良反应相关费用和总治疗成本均低于对照组,差异有统计学意义(P<0.05)。对照组与实验组临床有效率的成本-效果比(C/E)分别为126.22和110.14,增量成本-效果比(ΔC/ΔE)为410.41,细菌清除率的C/E分别为135.92和116.74,ΔC/ΔE为614.39。敏感性分析结果显示药品及相关治疗费用变化对本研究结果影响不大。结论利奈唑胺针剂与片剂联用治疗老年重症MRSA肺炎的临床疗效与静脉滴注给药相当,但能显著减少血小板下降的发生,同时,更具有经济学优势。Objective To explore the efficacy and economic analysis of linezolid with different medication regimens on methicillin-resistant Staphylococcus aureus(MRSA)severe pneumonia in elderly patients.Methods A total of 120 elderly patients with MRSA severe pneumonia diag-nosed in the department of Respiratory Medicine and Serious Medicine of People's Hospital of Qingyang City from May 2018 to December 2020 were selected as the research subjects,and they were divided into the control group and the experimental group according to random number table method,with 60 cases in each group.The control group was given 600 mg linezolid intravenously once every 12 h,the experimental group was given 600 mg linezolid intravenously at 9:00 AM and 600 mg linezolid tablet orally at 9:00 PM every day.The clinical efficacy,bacterial clearance rate,ad-verse reactions and pharmacoeconomic were compared between the two groups.Results There were no significant differences in total effective rate and bacterial clearance rate between the two groups.After treatment,the platelet count in the experimental group was lower than that in the con-trol group,the difference was statistically significant(P<0.05),but there was no significant difference in the incidence of thrombocytopenia be-tween the two groups.There were no significant differences in the cost of bed,examination,nursing,treatment and other drugs between the two groups;the cost of linezolid,the cost of adrs and the total cost of treatment in the experimental group were lower than those in the control group,the difference was statistically significant(P<0.05).The cost-effectiveness ratio(C/E)of total effective rate in the control group and the experimental group respectively were 126.22 and 110.14,incremental cost-effectiveness ratio(ΔC/ΔE)was 410.41;the C/E of bacterial clearance rate in the con-trol group and the experimental group respectively were 135.92 and 116.74,ΔC/ΔE was 614.39.Sensitivity analysis showed that changes in drug and related treatment costs had little effect on the

关 键 词：利奈唑胺 新型序贯疗法 耐甲氧西林金黄色葡萄球菌肺炎 老年 临床疗效 药物经济学 

分 类 号：R563.1[医药卫生—呼吸系统]