参附注射液联合利奈唑胺治疗耐甲氧西林金黄色葡萄球菌重症肺炎的临床观察

发布时间：2018-05-14 20:36

本文选题：耐甲氧西林金黄色葡萄球菌 + 重症肺炎　；参考：《中国药房》2017年20期

【摘要】：目的:观察参附注射液联合利奈唑胺治疗耐甲氧西林金黄色葡萄球菌(MRSA)重症肺炎患者的临床效果及安全性。方法:采用回顾性研究方法,选择2012年6月-2015年10月在我院重症监护病房治疗的62例MRSA重症肺炎患者的临床资料,按照用药方案分为观察组(25例)和对照组(28例)。在常规治疗的基础上,对照组患者给予利奈唑胺注射液600 mg,ivgtt,bid;观察组患者在对照组基础上加用参附注射液,首次静脉注射60 m L,随后以20 m L/h的速率持续静脉泵入60 m L,q12 h。两组患者均连续治疗2周。比较两组患者的临床疗效、细菌学疗效、治疗前后的心功能指标和血清炎症因子水平,以及不良反应发生情况。结果:观察组患者的临床有效率为88.00%,明显高于对照组的60.71%,差异有统计学意义(P0.05)。观察组患者的细菌清除率为72.00%,对照组患者为64.28%,组间比较差异无统计学意义(P0.05)。治疗前,两组患者的心功能指标和血清炎症因子水平比较,差异均无统计学意义(P0.05);治疗后,两组患者的左室射血分数、每搏输出量、心输出量和心脏排血指数均较治疗前明显升高,血清肿瘤坏死因子α、白细胞介素6、C反应蛋白和前降钙素水平均较治疗前明显降低,且观察组上述指标水平均明显优于对照组,差异均有统计学意义(P0.05)。两组患者治疗过程中均未见严重不良反应发生。结论:参附注射液联合利奈唑胺可有效改善MRSA重症肺炎患者的心功能,提高抗炎效果,临床疗效显著,且安全性较高。
[Abstract]:Objective: to observe the clinical effect and safety of Shenfu injection combined with linazolamide in the treatment of severe pneumonia with methicillin-resistant staphylococcus aureus. Methods: the clinical data of 62 patients with MRSA severe pneumonia who were treated in our hospital from June 2012 to October 2015 were retrospectively studied. The patients were divided into observation group (n = 25) and control group (n = 28). On the basis of routine treatment, the patients in the control group were treated with linazolamine injection 600 mg / d iv gttbidin, and the patients in the observation group were treated with Shenfu injection 60 mL / h for the first time, followed by continuous intravenous infusion of 60 mL / h for 12 h at the rate of 20 mL / h. The patients in both groups were treated continuously for 2 weeks. The clinical efficacy, bacteriological effect, cardiac function index, serum inflammatory factor level and adverse reaction were compared between the two groups. Results: the clinical effective rate of the observation group was 88.00, which was significantly higher than that of the control group (60.71%), and the difference was statistically significant (P 0.05). The bacterial clearance rate was 72.00 in the observation group and 64.28 in the control group. There was no significant difference between the two groups (P 0.05). Before treatment, there was no significant difference in cardiac function index and serum inflammatory factor level between the two groups, and after treatment, left ventricular ejection fraction (LVEF) and stroke output were not significantly different between the two groups. The cardiac output and cardiac blood excretion index were significantly increased, and the serum levels of tumor necrosis factor 伪, interleukin-6 C-reactive protein and procalcitonin were significantly lower in the observation group than in the control group, and the above indexes in the observation group were significantly higher than those in the control group. The difference was statistically significant (P 0.05). No serious adverse reactions occurred during treatment in both groups. Conclusion: Shenfu injection combined with linazolamide can effectively improve the cardiac function of MRSA patients with severe pneumonia, improve the anti-inflammatory effect, the clinical efficacy is significant, and the safety is high.
【作者单位】：自贡市第四人民医院重症医学科;
【分类号】：R563.1

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