摘要
目的观察利奈唑胺、替考拉宁和万古霉素在脑梗死患者医院耐甲氧西林的金黄色葡萄球菌(MRSA)肺炎的临床效果。方法选取医院2013年1月-2016年1月收治的120例发生院内MRSA肺炎的脑梗死患者为研究对象,将患者随机分为3组,每组各40例,为利奈唑胺组、替考拉宁组及万古霉素组,利奈唑胺组患者给予利奈唑胺注射液600mg,静脉滴注,一日两次;替考拉宁组给予替考拉宁注射液0.4g,静脉滴注,一日两次;万古霉素组给予盐酸万古霉素注射液1000mg,静脉滴注,一日两次;治疗时间均为2周,治疗结束后观察比较3组患者的临床疗效、细菌清除有效率以及患者的不良反应发生率。结果利奈唑胺组患者治疗总有效率为85.00%,替考拉宁组为70.00%,万古霉素组为67.50%,利奈唑胺组治疗有效率显著高于替考拉宁组和万古霉素组(P<0.05);利奈唑胺组患者细菌清除有效率为87.50%,替考拉宁组为60.00%,万古霉素组为55.00%,利奈唑胺组细菌清除有效率显著高于替考拉宁组和万古霉素组(P<0.05);利奈唑胺组患者的不良反应发生率为5.00%,替考拉宁组为5.00%,万古霉素组为7.50%,三组患者不良反应发生率差异无统计学意义,发生率均较低且无严重不良反应发生。结论相比于替考拉宁和万古霉素,利奈唑胺治疗脑梗死患者院内MRSA感染具有显著优势,能更有效的清除MRSA,改善患者病情,且具有较好的安全性。
OBJECTIVE To observe the clinical effects of linezolid,teicoplanin,and vancomycin on treatment of cerebral infarction patients with nosocomial methicillin-resistant Staphylococcus aureus（MRSA）pneumonia.METHODS A total of 120 patients with nosocomial MRSA pneumonia who were treated in the hospital from Jan2013 to Jan 2016 were recruited as the study objects and randomly divided into three groups,with 40 cases in each group,which were namely the linezolid group,the teicoplanin group,and the vancomycin group.The linezolid group was given intravenous drip of 600 mg of linezold injection,twice a day;the teicoplanin group was treated with intravenous drip of 0.4g of teicoplanin injection,twice a day;the vancomycin group was given intravenous drip of 1000 mg of vancomycin hydrochloride injection,twice a day;the treatment time was two weeks.The clinical efficacy,effective rate of clearance of bacteria,and incidence of adverse reactions were observed and compared among the three groups of patients after the treatment.RESULTS The total effective rate of treatment was 85.00%in the linezolid group,significantly higher than 70.00%in the teicoplanin group and 67.50%in the vancomycin group（P〈0.05）.The effective rate of clearance of bacteria was 87.50% in the linezolid group,significantly higher than 60.00%in the teicoplanin group and 55.00%in the vancomycin group（P〈0.05）.The incidence of adverse reactions was 5.00%in the linezolid group,5.00%in the teicoplanin group,7.50%in the vancomycin group,and there was no significant difference in the incidence of adverse reactions among the three groups of patients,the incidence was relatively low,and no patient had severe adverse reactions.CONCLUSION As compared with teicoplanin and vancomycin,linezolid has significant advantage in treatment of the cerebral infarction patients with nosocomial MRSA pneumonia,eradicate the MRSA strains more effectively,and improve the patients＇ illness condition,with the safety high.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第6期1271-1274,共4页
Chinese Journal of Nosocomiology
基金
河南省卫生厅科技攻关基金资助项目(201304021)
