利奈唑胺治疗耐甲氧西林金黄色葡萄球菌肺炎的疗效及安全性分析

The analysis on effect and safety of Linezolid in the treatment of MRSA pneumonia

目的评价利奈唑胺治疗耐甲氧西林金黄色葡萄球菌(MRSA)所致肺炎的疗效及安全性。方法回顾性分析中国医科大学附属第一医院呼吸科重症监护病房(MICU)2009年5月至12月接受利奈唑胺治疗的16例患者(其中新型甲型H1N1流感患者7例),用药期间观察患者发热及其他临床症状、体征改善情况、影像学改变、监测血常规、肝肾功能及病原学改变,并根据上述结果决定利奈唑胺疗程。结果 16例中13例好转出院,3例死亡,2例血红蛋白降低,3例血小板降低,2例合并肾功能异常及9例合并肝功能异常患者,在应用利奈唑胺后肝肾功结果未见升高。结论利奈唑胺是治疗MRSA肺炎既有效又安全的药物。对于可能存在MRSA感染风险的高危患者可经验性应用利奈唑胺。

Objective To investigate the effect and safety of Linezolid in the treatment of MRSA pneumonia. Methods We retrospectively analyzed 16 cases administered with Linezolid （7 of the 16 cases were with influenza A （H1N1） in MICU of our hospital from May to December of 2009. Changes of clinical symptoms （e. g. fever）, physical signs, imaging change, blood routine tests, liver and kidney functions, and etiology were analyzed, with Linezolid treatment courses determined on the above findings. Results Of the 16 cases, 13 cases were discharged with a better health condition,while 3 cases died. 2 cases experienced decreased hemoglobin levels,3 cases underwent thrombocytopenia. Of the 2 cases combining with renal dysfunction and the 9 cases combining with dysfunction of liver, no increase of liver and kidney functions values were noted after Linezolid treatment. Conclusion Linezolid is safe and effective in the treatment of MRSA pneumonia. For patients in a high risk of MRSA infection, Linezolid may be applied according to clinical experience.