亚胺培南/西司他丁与美罗培南治疗尿源性脓毒血症的有效性、安全性及经济性评价  

The evaluation of effectiveness,safety,and economy of imipenem/cilastatin and meropenem in the treatment of urosepsis

作　　者：杜江 苟成仁 王培睿 郑宜 梁国标 Du Jiang;Gou Chenren;Wang Peirui;Zheng Yi;Liang Guobiao(Department of Urology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;Department of Urology,The People’s Hospital of Wuchuan,Wuchuan Guizhou 564300,China)

机构地区：[1]遵义医科大学附属医院泌尿外科,贵州遵义563000 [2]务川自治县人民医院泌尿外科,贵州务川564300

出　　处：《遵义医科大学学报》2024年第12期1217-1221,共5页Journal of Zunyi Medical University

摘　　要：目的 探讨亚胺培南/西司他丁及美罗培南在治疗尿源性脓毒血症的有效性、安全性及经济性方面是否具有差异。方法 回顾分析2018年6月至2022年12月期间收治的39例尿源性脓毒血症且使用亚胺培南/西司他丁(亚胺组,n=16例)或美罗培南(美罗组,n=23例)抗感染治疗病患的临床资料。比较两组患者治疗前后相关炎性指标、血小板及血肌酐值的变化情况,评价两组药物临床疗效和对比不良反应发生率是否有差异,并进行成本效果分析。结果 亚胺组与美罗组总有效率均为100%。两组总有效病人治疗后血白细胞总数、中性粒细胞百分比、降钙素原及超敏C反应蛋白显著低于治疗前,且差异有统计学意义(P<0.05);组间比较时,两组指标无差异。将两组总有效病人中合并血小板减少症患者治疗前后血小板值变化分别进行对比,治疗后血小板值较治疗前明显回升或恢复至正常水平(P<0.05);而两组指标组间比较无差异;在合并急性肾衰的患者中,治疗后的血肌酐值较治疗前明显下降或恢复至正常水平(P<0.05)。两组药物在使用过程中,均未发生严重药物不良反应,且不良反应发生率对比无差异。成本效果分析结果显示,美罗组患者的抗菌药物使用成本高于亚胺组(P<0.05)。结论 亚胺培南/西司他丁及美罗培南用于治疗尿源性脓毒血症时具有相当的有效性及安全性,但前者在经济性方面更优于后者。Objective To investigate the effectiveness,safety,and economy of imipenem/cilastatin and meropenem in the treatment of patients with urosepsis.Methods Clinical data of 39 patients with urosepsis received imipenem/cilastatin(n=16)and meropenem(n=23)were collected in our hospital from June 2018 to December 2022.Inflammatory markers,platelet,creatinine,clinical efficacy and the occurrence of adverse drug reactions(ADRs)were compared between the two groups before and after treatment.Then cost-effectiveness were analyzed.Results The total effective rates were 100%for both imipenem/cilastatin and meropenem group.In addition to patients who were not responding to treatment,white blood cell count,neutrophil percentage,procalcitonin,and hypersensitive C-reactive protein were lower than before treatment,with statistical significance(P<0.05).However,there was no statistical significance for these indices between the two groups.Comparison of platelet values before and after treatment for both the two groups of patients showed effective therapy.After treatment,platelet values were significantly increased compared to before treatment or returned to normal levels(P<0.05).Here was no statistical significance for this index between the two groups.For patients with acute renal failure,the creatinine values after treatment were lower than before or returned to normal levels(P<0.05).The rates of adverse reactions in the two groups were not statistically significant.Cost-effectiveness analysis showed that the cost of meropenem was more expensive than imipenem/cilastatin(P<0.05).Conclusion The effectiveness and safety of imipenem/cilastatin are similar to meropenem.In terms of economy,imipenem/cilastatin is better than meropenem.

关 键 词：尿脓毒血症 亚胺培南/西司他丁 美罗培南 有效性 安全性 经济性 

分 类 号：R691.3[医药卫生—泌尿科学]