替加环素治疗多重耐药菌所致重症肺炎的效果及对氧代谢状态的影响

摘要
图/表
参考文献(23)
相关文章 (5)

全文: PDF (341 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨替加环素治疗多重耐药菌所致重症肺炎的效果及对氧代谢状态的影响。方法选择2016年10月～2017年11月于大连市中心医院确诊的92例多重耐药菌所致重症肺炎患者，依据治疗方式的不同将其分为对照组和研究组，每组各46例。对照组给予头孢哌酮舒巴坦静滴治疗，研究组在对照组治疗的基础上给予替加环素静脉滴注。两组均治疗3 d。观察比较两组治疗后的效果，检测两组患者治疗前1 d和治疗后3 d的氧代谢状态（氧供与氧耗状态），比较两组治疗中的不良反应发生率。结果治疗后，研究组的疗效优于对照组，差异有统计学意义（P < 0.05）；治疗后3 d，两组氧供（DO2）及氧供指数（DO2I）、氧耗（VO2）及氧耗指数（VO2I）、动脉血氧分压（PaO2）及动脉血氧饱合度（SaO2）均明显高于治疗前，差异有统计学意义（P < 0.05），且研究组治疗后3 d的DO2、DO2I、VO2、VO2I、PaO2及SaO2检测值均明显高于对照组，差异有统计学意义（P < 0.05）；两组治疗过程中腹泻、恶心、呕吐及皮疹等不良反应发生率比较差异无统计学意义（P > 0.05）。结论替加环素治疗多重耐药菌所致重症肺炎患者的效果较好，有助于改善患者的氧代谢状态，且未明显增加不良反应，值得推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	张妍苏晓蕾赵睿韩世权▲ 朱虹房开宇陈晓园

关键词 ：替加环素, 头孢哌酮舒巴坦, 多重耐药菌, 重症肺炎, 氧代谢状态

Abstract：Objective To investigate the effect of Tigecycline in the treatment of severe pneumonia caused by multidrug resistant bacteria and its influence on oxygen metabolism state. Methods From October 2016 to November 2017, 92 patients diagnosed as severe pneumonia caused by multidrug resistant bacteria in Dalian Municipal Central Hospital were selected and divided into control group and study group according to the different treatment methods, with 46 cases in each group. The control group was treated with Cefoperazone-Sulbactam by intravenous drip, the study group was treated with Tigecycline by intravenous drip on the basis of treatment of control group. The treatment of two groups lasted for 3 d. The curative effects of the two groups were observed and compared after treatment, the oxygen metabolism state (oxygen supply and oxygen consumption state) of two groups were detected 1 d before treatment and 3 d after treatment, and the adverse reactions rates of the two groups during the treatment were compared. Results After treatment, the curative effect of study group was significantly better than that of control group, the difference was statistically significant (P < 0.05). The oxygen supply (DO2) and oxygen supply index (DO2I), oxygen consumption (VO2) and oxygen consumption index (VO2I), arterial oxygen pressure (PaO2) and arterial oxygen saturation (SaO2) of the two groups 3 d after treatment were higher than those before treatment, the differences were statistically significant (P < 0.05), and the detection values of DO2, DO2I, VO2, VO2I, PaO2 and SaO2 of study group 3 d after treatment were significantly higher than those of control group, the differences were statistically significant (P < 0.05). There were no significant differences in the rates of adverse reactions including diarrhea, nausea, vomiting and rash during treatment between the two groups (P > 0.05). Conclusion Tigecycline is effective in the treatment of patients with severe pneumonia caused by multidrug resistant bacteria, which is helpful to improve the oxygen metabolism, and there is no obvious increase in adverse reactions, so it is worthy of promotion and application.

Key words： Tigecycline Cefoperazone-Sulbactam Multidrug resistant bacteria Severe pneumonia Oxygen metabolism state

通讯作者: ▲通讯作者

引用本文:

张妍苏晓蕾赵睿韩世权▲ 朱虹房开宇陈晓园. 替加环素治疗多重耐药菌所致重症肺炎的效果及对氧代谢状态的影响[J]. 中国医药导报, 2018, 15(27): 106-109.
ZHANG Yan SU Xiaolei ZHAO Rui HAN Shiquan▲ ZHU Hong FANG Kaiyu CHEN Xiaoyuan. Effect of Tigecycline in the treatment of severe pneumonia caused by multidrug resistant bacteria and its influence on oxygen metabolism state. 中国医药导报, 2018, 15(27): 106-109.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I27/106

[1] 解玉东.替加环素联合头孢哌酮钠-舒巴坦钠治疗肺部泛耐药鲍曼不动杆菌感染的临床研究[J].中国执业药师，2017，15（5）：30-33.
[2] Neyra RC，Frisancho JA，Rinsky JL，et al. Multidrug-Resistant and Methicillin-Resistant Staphylococcus aureus（MRSA）in hog slaughter and processing plant workers and their community in North Carolina（USA）[J]. Environ Health Perspect，2014，122（5）：471-477.
[3] 王青青，宋相孔，武静，等.替加环素联合头孢哌酮/舒巴坦治疗重症颅脑外伤患者耐药鲍氏不动杆菌感染的效果研究[J].中华医院感染学杂志，2016，26（7）：1468-1470.
[4] 孟冬梅，刘志军.替加环素在多重耐药鲍曼不动杆菌肺炎治疗中的临床效果[J].北方药学，2016，13（3）：101-102.
[5] 《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则[M].北京：人民卫生出版社，2015：110-111.
[6] 熊旭东.不同剂量替加环素对细菌性重症感染患者的临床疗效及其耐药性评价[J].抗感染药学，2016，13（1）：35-39.
[7] De Pascale G，Montini L，Pennisi M，et al. High dose tigecycline in critically ill patients with severe infections due to multidrug-resistant bacteria [J]. Crit Care，2014，18（3）：R90.
[8] 王辉，李略，李海峰，等.舟山海岛地区多重耐药鲍曼不动杆菌调查及替加环素对其药物敏感性研究[J].中国现代医生，2017，55（23）：109-111.
[9] 臧会玲，王生池，程慧，等.替加环素联合头孢哌酮/舒巴坦治疗多重耐药及泛耐药鲍曼不动杆菌临床效果分析[J].中国综合临床，2016，32（1）：41-43.
[10] Park GC，Choi JA，Jang SJ，et al. In vitro interactions of antibiotic combinations of Colistin, Tigecycline, and Doripenem against extensively Drug-Resistant and Multidrug-Resistant Acinetobacter baumannii [J]. Ann Lab Med，2016，36（2）：124-130.
[11] Linkevicius M，Sandegren L，Andersson DI. Potential of Tetracycline resistance proteins to evolve Tigecycline resistance [J]. Antimicrob Agents Chemother，2016，60（2）：789-796.
[12] 何群，朱宇，蒋芬芬，等.替加环素治疗呼吸机相关性肺炎患者泛耐药鲍氏不动杆菌感染的临床研究[J].中华医院感染学杂志，2016，26（6）：1229-1231.
[13] 祁亚平.经鼻持续气道正压通气对重症肺炎合并呼吸衰竭患儿血气及氧代谢指标的影响[J].社区医学杂志，2017，15（15）：57-58.
[14] 刘行仁，甘露，杨雁.双水平无创正压通气配合低分子肝素对慢性阻塞性肺病患者肺功能及氧代谢的影响[J].中国医药导刊，2016，18（10）：980-982.
[15] Trebosc V，Gartenmann S，Royet K，et al. A novel genome-editing platform for drug-resistant Acinetobacter baumannii reveals an AdeR-Unrelated Tigecycline Resistance Mechanism [J]. Antimicrob Agents Chemother，2016， 60（12）：7263-7271.
[16] 许国斌，朱金强，张近波，等.替加环素联合头孢哌酮/舒巴坦治疗泛耐药鲍曼不动杆菌老年重症肺炎的临床疗效[J].中国老年学杂志，2016，36（7）：1649-1651.
[17] 张东，李晶，杨艺敏，等.替加环素在重症患者经验性抗感染治疗中的临床疗效[J].实用药物与临床，2015，18（10）：1189-1192.
[18] 黄健，张志大.替加环素联合头孢哌酮舒巴坦治疗多重耐药鲍曼不动杆菌肺部感染的临床效果[J].中国当代医药，2016，23（13）：145-147.
[19] 张可，蔡文伟，许秋然.替加环素和头孢哌酮钠舒巴坦钠治疗多重耐药鲍曼不动杆菌肺炎的比较研究[J].中华危重症医学杂志：电子版，2016，9（2）：116-119.
[20] 何鲤穗，刘玉琪，洪思白，等.替加环素治疗泛耐药鲍曼不动杆菌医院获得性肺炎的临床分析[J].河北医科大学学报，2015，36（12）：1432-1435.
[21] 魏威，李龙.泛耐药鲍曼不动杆菌所致呼吸机相关性肺炎应用替加环素治疗的临床疗效[J].中国医药科学，2017，7（10）：22-24，34.
[22] 刘彬森.替加环素治疗ICU患者泛耐药鲍氏不动杆菌肺部感染的效果分析[J].中国当代医药，2016，23（27）：110-112.
[23] 刘燕，郑海霞，房敏.观察替加环素联合头孢哌酮舒巴坦治疗多重耐药鲍曼不动杆菌肺炎的临床疗效[J].中国继续医学教育，2016，8（15）：153-154.