替考拉宁注射剂治疗耐甲氧西林金黄色葡萄球菌肺部感染患者的临床研究

Clinical trial of teicoplanin injection in the treatment of methicillin-resistant staphylococcus aureus lung infection

目的观察不同剂量替考拉宁注射剂治疗耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染的临床疗效及安全性。方法随机分为对照组和试验组,每组35例。对照组给予替考拉宁每次400 mg,q12 h,静脉滴注,3次后,改为qd;试验组给予替考拉宁每次400 mg,q12 h,静脉滴注,3次后,改为每次600 mg,qd,静脉滴注。2组患者均治疗2周。比较2组患者的临床疗效、细菌总清除率、血清炎症指标水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为88.57%(31例/35例)和68.57%(24例/35例),细菌总清除率分别为91.43%(32例/35例)和71.43%(25例/35例),差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组的C反应蛋白分别为(13.28±4.11)和(20.04±6.36)mg·L^-1,肿瘤坏死因子-α分别为(48.57±6.19)和(61.73±8.46)pg·m L^-1,白细胞介素-1β分别为(153.29±19.73)和(181.64±22.95)pg·m L^-1,降钙素原分别为(0.32±0.04)和(0.41±0.05)ng·m L^-1,差异均有统计学意义(均P<0.05)。2组患者发生的药物不良反应均以恶心、腹泻、皮疹和肝肾功能异常为主。试验组和对照组的药物不良反应发生率分别为17.14%和14.29%,差异无统计学意义(P>0.05)。结论大剂量替考拉宁注射剂治疗MRSA肺部感染的临床疗效确切,其能显著地提高细菌总清除率,降低炎症指标水平,且不增加药物不良反应的发生率。

Objective ferent dosages of teicoplanin injection in the treatment of methicillin-resistant staphylococcus aureus(MRSA)lung infection.Methods of 70 patients with MRSA lung infection were randomly divided into control group and treatment group with 35 cases per group.Control group was treated with teicoplanin 400 mg per time,q12 h,intravenous drip,and was then changed to qd after 3 times.Treatment group was received teicoplanin 400 mg per time,q12 h,intravenous drip,and was then changed to 600 mg per time,qd,intravenous drip after 3 times.Two groups were treated for 2 weeks.The clinical efficacy,total bacterial clearance rate,serum levels of inflammatory markers and adverse drug reactions were compared between two groups.Results the total effective rates in treatment and control groups were 88.57%(31 cases/35 cases)and 68.57%(24 cases/35 cases),the total bacterial clearance rates were 91.43%(32 cases/35 cases)and 71.43%(25 cases/35 cases),the differences were statistically significant(all P<0.05).After treatment,the main indexes of treatment and control groups were compared:C reactive protein were(13.28±4.11)and(20.04±6.36)mg·L^-1,tumor necrosis factor-αwere(48.57±6.19)and(61.73±8.46)pg·m L^-1,interleukin-1βwere(153.29±19.73)and(181.64±22.95)pg·m L^-1,procalcitonin were(0.32±0.04)and(0.41±0.05)ng·m L^-1,the differences were statistically significant(all P<0.05).The adverse drug reactions of two groups were nausea,diarrhea,rash,liver and kidney dysfunction.The total incidences of adverse drug reactions in treatment and control groups were 17.14%and 14.29%without significant difference(P>0.05).Conclusion high dose of teicoplanin injection has a definitive clinical efficacy in the treatment of MRSA lung infection,which can significantly improve the total bacterial clearance rate,and reduce the levels of inflammatory markers,without increasing the incidence of adverse drug reactions.