美罗培南延长输注时间治疗老年人医院获得性肺炎的临床研究
发布时间：2018-11-14 15:36
【摘要】：目的比较美罗培南常规输注(30 min)和延长输注时间(3 h)两种给药方法治疗老年人医院获得性肺炎(HAP)的临床疗效和安全性,观察肾清除率增加(ARC)对临床疗效的影响。方法采用开放性随机对照临床单盲研究。选择2015年9月-2016年8月住院的需要使用美罗培南治疗的老年HAP患者40例。随机分为对照组、研究组各20例。对照组给药方案为美罗培南1 g加入0.9%Na Cl溶液100 m L中,使用静脉输液泵匀速维持30 min,每8小时给药1次;研究组给药方案为美罗培南1 g加入0.9%Na Cl溶液100 m L中,使用输液泵匀速维持3 h,每8小时给药1次。两组至少用药7 d。比较两组患者的临床疗效和药物不良反应。进一步将40例患者中肌酐清除率(Ccr)≥130(m L/min)/1.73 m2的患者列为A1组,其余患者列为A2组。将对照组和研究组中Ccr≥130(m L/min)/1.73 m2的患者分别列为B1组和B2组。单独比较A1组和A2组,B1组和B2组的临床疗效。结果与对照组比较,研究组临床治愈率和28 d生存率明显升高[临床治愈率:70.00%(14/20)比50.00%(10/20);28 d生存率:85.00%(17/20)比65.00%(13/20),P均0.05],临床肺部感染评分(CPIS)、降钙素原(PCT)明显改善[CPIS降低值(分):(2.88±2.51)比(1.25±1.67);PCT降低值(μg/L):(2.43±0.68)比(1.05±0.27),P均0.05],而美罗培南治疗天数、住院时间无明显差异(P?0.05)。两组患者的主要不良反应为血清丙氨酸转氨酶升高及腹泻,不良反应发生率无明显差异(P0.05)。进一步分析,与A2组比较,A1组临床治愈率,28 d生存率明显降低[临床治愈率:44.44%(4/9)比64.52%(20/31);28 d生存率:66.67%(6/9)比77.42%(24/31),P均0.05],CPIS评分及PCT下降值亦有明显差异[CPIS降低值(分):1.62±1.61比2.19±2.2;PCT降低值(μg/L):(1.41±0.39)比(1.84±0.5),P均0.05],而美罗培南治疗天数、住院时间无明显差异。与B1组比较,B2组的临床治愈率、28 d生存率明显提高(临床治愈率:3/5比1/4;28 d生存率:4/5比2/4,P均0.05),CPIS评分、PCT值明显改善[CPIS降低值(分):(2.56±2.29)比(0.68±0.93);PCT降低值(μg/L):(2.21±0.63)比(0.61±0.15),P均0.05],美罗培南治疗天数、住院时间无明显差异(P0.05)。结论与30 min常规输注给药方法相比,延长美罗培南输注时间至3 h可以提高老年HAP患者的临床疗效,不良反应未增加。ARC导致患者临床疗效下降,通过延长美罗培南输注时间可提高ARC患者的临床疗效。
[Abstract]:Objective to compare the clinical efficacy and safety of routine meropenem infusion (30 min) and prolonged infusion time (3 h) in the treatment of (HAP) in elderly patients with nosocomial pneumonia. To observe the effect of increasing renal clearance rate (ARC) on clinical efficacy. Methods an open randomized controlled clinical single blind study was used. Forty elderly HAP patients who were hospitalized with meropenem from September 2015 to August 2016 were selected. The patients were randomly divided into control group (n = 20). In the control group, 1 g of meropenem was added to 100ml of 0.9%Na Cl solution, and the intravenous infusion pump was used to maintain the drug at a constant rate of 30 min, every 8 hours. In the study group, meropenem 1 g was added to 100ml 0.9%Na Cl solution, and the infusion pump was used for 3 h, once every 8 hours. The two groups were treated for at least 7 days. The clinical efficacy and adverse drug reactions were compared between the two groups. 40 patients with creatinine clearance (Ccr) 鈮，
本文编号：2331578
[Abstract]:Objective to compare the clinical efficacy and safety of routine meropenem infusion (30 min) and prolonged infusion time (3 h) in the treatment of (HAP) in elderly patients with nosocomial pneumonia. To observe the effect of increasing renal clearance rate (ARC) on clinical efficacy. Methods an open randomized controlled clinical single blind study was used. Forty elderly HAP patients who were hospitalized with meropenem from September 2015 to August 2016 were selected. The patients were randomly divided into control group (n = 20). In the control group, 1 g of meropenem was added to 100ml of 0.9%Na Cl solution, and the intravenous infusion pump was used to maintain the drug at a constant rate of 30 min, every 8 hours. In the study group, meropenem 1 g was added to 100ml 0.9%Na Cl solution, and the infusion pump was used for 3 h, once every 8 hours. The two groups were treated for at least 7 days. The clinical efficacy and adverse drug reactions were compared between the two groups. 40 patients with creatinine clearance (Ccr) 鈮，
本文编号：2331578
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