硫酸多黏菌素B治疗造血干细胞移植术后重症感染的临床分析  

Clinical efficacy of polymyxin B in the treatment of severe infection after hematopoietic stem cell transplantation

作　　者：李欣桐 郑焱华 任芮林 许敏 何春晓 温雪梅 李乃农[1] 李晓帆[1] Li Xintong;Zheng Yanhua;Ren Ruilin;Xu Min;He Chunxiao;Wen Xuemei;Li Nainong;Li Xiaofan(Fujian Institute of Hematology,Fujian Provincial Key Laboratory on Hematology,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建省血液病研究所、福建医科大学附属协和医院血液科,福州350001

出　　处：《中华细胞与干细胞杂志(电子版)》2025年第1期51-56,共6页Chinese Journal of Cell and Stem Cell(Electronic Edition)

基　　金：国家重点研发计划资助(2022YFC2502700);国家临床重点专科建设项目(闽卫医政[2021]76号);福建省自然科学基金项目(2021J01782);福建省卫健委中青年骨干人才培养项目(2021GGA018);福建省恶性血液病临床医学研究中心(2020Y2006)。

摘　　要：目的探讨以多黏菌素B为基础联合其他抗生素治疗造血干细胞移植术后重症感染患者的临床疗效。方法回顾性分析58例使用多黏菌素B联合其他抗生素治疗造血干细胞移植术后重症感染患者的临床相关资料。按照多黏菌素B治疗的持续用药时间分组,分为≤7 d组(27例)和>7 d组(31例)。比较各组患者细菌总清除率、治疗有效率的差异。两组间定量数据的比较采用独立样本t检验或Mann-Whitney U检验,两组间定性数据的比较采用χ^(2)检验或Fisher精确检验法。两组间生存数据的比较采用Kaplan-Meier生存曲线法。结果治疗持续时间>7 d组治疗后细菌清除率(48.39%比22.22%)、治疗有效率(70.97%比44.44%)较≤7 d组升高,且两组上述指标比较差异有统计学意义(P均<0.05)。结论对于造血干细胞移植术后重症感染患者,多黏菌素B应足疗程与其他抗感染药物联合使用,可能更有利于患者获益。Objective To investigate the clinical efficacy of polymyxin B combined with other antibiotics in the treatment of severe infection after hematopoietic stem cell transplantation.Methods Clinical data of 58 patients with severe infection after hematopoietic stem cell transplantation treated with polymyxin B combined with other antibiotics were retrospectively analyzed.Patients were divided into 2 groups based on the duration of polymyxin B treatment[≤7 d group(27 cases),>7 d group(31 cases)].The total bacterial clearance rate and effective rate were compared between two groups.The quantitative data between the two groups were compared by independent sample t test or Mann-Whitney U test,and the qualitative data between the two groups were compared byχ^(2) test or Fisher exact test.Survival data between the two groups were compared using Kaplan-Meier survival curve method.Results Compared with the treatment duration≤7 days group,the total bacterial clearance rate(48.39%vs 22.22%)and treatment effectiveness(70.97%vs 44.44%)were increased in the treatment duration>7 days group.Conclusion For patients with severe infection after hematopoietic stem cell transplantation,polymyxin B should be combined with other anti-infective drugs for a full course of treatment to benefit patients.

关 键 词：造血干细胞移植 多黏菌素B 耐碳青霉烯 革兰阴性菌 

分 类 号：R47[医药卫生—护理学]