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危重症患者革兰阴性杆菌感染抗生素治疗诱导内毒素释放差异比较 被引量:2

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摘要 目的探讨不同抗生素治疗危重症患者革兰阴性杆菌感染诱导内毒素和TNF-α释放异质性。方法90例危重症患者,经临床表现和细菌学证实革兰阴性杆菌感染,60例患者采用不同敏感性抗生素治疗:头孢呋辛9例;头孢曲松9例;头孢他啶8例;头孢吡肟8例;阿米卡星9例;环丙沙星9例;亚胺培南8例。另30例患者均用头孢他啶治疗。采用鲎试验基质偶氮显色法测定体内抗生素治疗前后不同时间内毒素含量,采用ELISA测定相应时间TNF-α含量,进行统计学分析。结果不同细菌种类头孢他啶治疗致内毒素释放量和速率相似(P>0.05)。不同抗生素致内毒素释放速率存在一定的差异,其中亚胺培南/西司他丁和孢吡肟释放最快,其次为头孢呋辛、头孢他啶和环丙沙星,阿米卡星较慢,而头孢曲松最为缓慢。观察总的内毒素释放量,我们发现头孢曲松最多,而头孢呋辛、头孢他啶和环丙沙星次之,亚胺培南/西司他丁和头孢吡肟较少,阿米卡星最少。同时我们发现抗生素诱导TNF-α释放量和趋势与LPS一致。结论不同抗生素治疗革兰阴性杆菌感染诱导内毒素释放存在一定的差异,提示我们在临床工作应选择性使用敏感性抗生素。
出处 《广东医学》 CAS CSCD 北大核心 2008年第9期1517-1519,共3页 Guangdong Medical Journal
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