莫昔沙星与头孢甲肟+甲硝唑治疗胰腺疾病合并腹腔感染的随机对照研究

Randomized controlled trial of moxifloxacin vs cefmenoxime plus arilin in treating pancreatic diseases associated with abdominal infection

目的评价莫昔沙星对胰腺疾病合并腹腔感染病人治疗的有效性和安全性。方法采用随机、双盲、对照及开放试验将临床确诊为胰腺疾病合并腹腔感染的病人随机分为实验组和对照组。实验组每日应用莫昔沙星400mg;对照实验组每日应用头孢甲肟4g+甲硝唑1.25g,疗程均为7～14d。记录两组病人APACHⅡ评分、血常规及肝、肾功能等,并统计分析其疗效。结果两组各有24例可进行疗效与安全性评价。APACHⅡ评分≤12病人的临床治愈率分别为71.4%和75%,无显著性差异;APACHⅡ评分>12病人的临床治愈率分别为40%和58.3%,有显著性差异;不良反应发生率莫昔沙星组为16.7%,头孢甲肟+甲硝唑组为20.8%。结论对于胰腺疾病合并腹腔感染病人的抗生素治疗,当APACHII评分≤12时,可选择莫昔沙星作为经验用药。

Objective To evaluate the efficacy and safety of moxifloxacin in abdominal infection therapy of pancreatic diseases. Methods The patients with pancreatic diseases associated with abdominal infection were randomly arranged to receive either moxifloxacin 400 mg every day for 7- 14 days （experimental group）or cefmenoxime 4. 0 g plus arilin 1.25 g every day for 7 - 14 days（control group）. Their vital signs, APACH Ⅱ score, blood routine, liver function and renal function were recorded. The mortality and the clinically healing rate were analyzed. Results In each group there were 24 cases who received curative effect evaluation and safety evaluation. When APACH Ⅱ score was below 12 the clinically healing rate in experimental group and control group was 71.4% and 75% respectively （P〉0. 05）. While APACH Ⅱ score was above 12, the clinically healing rate in both groups was 40% and 58.3% with the difference being significant. The incidence of adverse effect in experimental group and control group was 16. 7% and 20. 8% respectively. Conclusion When APACH Ⅱ score was below 12, single-agent moxifloxacin could be selected as a experience therapy in pancreatic diseases associated with abdominal infection.