莫西沙星对早发无多重耐药危险因素医院获得性肺炎的临床疗效

Clinical Effect of Moxifloxacin in the Treatment of Early and No Risk Factory for MDR Hospital-acquired Pneumonia

目的观察莫西沙星对早发且无多重耐药危险因素的医院获得性肺炎临床疗效及预后影响。方法选取早发且无多重耐药危险因素的医院获得性肺炎患者60例,随机分为治疗组和对照组各30例。治疗组给予盐酸莫西沙星0.4g,加入0.9%氯化钠注射液250mL静脉滴注,qd;对照组给予头孢曲松钠2.0g,加入0.9%氯化钠注射液250mL静脉滴注,qd,两组均治疗7d,期间不联用其他抗菌药物,观察临床肺部感染评分(CPIS)、C反应蛋白(CRP)、细菌清除率、临床疗效,预后及安全性。结果治疗组有效率83.3%,对照组为66.7%。治疗组CPIS由治疗前(6.9±1.1)分降为(3.0±1.9)分,CRP由治疗前(43.0±5.1)降为(17.6±3.9)mg.L-1;对照组CPIS由(7.1±1.4)分降为(4.6±1.7)分,CRP由(41.5±6.3)降为(30.8±4.4)mg.L-1。治疗组细菌清除率为81.0%,对照组为63.2%。治疗组晚发医院获得性肺炎发生率为6.7%,病死率3.3%,对照组分别为16.7%和10.0%。结论莫西沙星治疗早发且无多重耐药危险因素的医院获得性肺炎能及早改善临床症状、缩短疗程和改善预后,疗效确切,安全性好。

Objective To study the clinical effect and prognosis of moxifloxacin in the treatment of early and no risk factory for MDR hospital-acquired pneumonia.Methods 60 cases of early and no risk factory for MDR hospital-acquired pneumonia were randomly divided into moxifloxacin（0.4 g ivgtt qd for 7 d） treatment group（30 cases）and ceftriaxone（2.0 g ivgtt qd for 7 d） treatment group（30 cases）.The clinical indicators（CPIS,CRP）,clinical results,clearance of pathogens,prognosis and security were observed.Results After treatment,the efficacy of the treatment group was 83.3%,the control was 66.7%.CPIS in the treatment group droped from（6.9±1.1）down to（3.0±1.9）,CRP from（43.0±5.1）down to（17.6±3.9） mg.L-1;while CPIS in the control group declined from（7.1±1.4）to（4.6±1.7）,CRP from（41.5±6.3）down to（30.8±4.4）mg.L-1.The pathogens clearance in the treatment and control groups was 81.0% and 63.2%,respectively.The incidence of later HAP and mortality in the treatment group was 6.7% and 3.3%,respectively;those in the control group was 16.7% and 10.0%,respectively.Conclusion Moxifloxacin can improve the clinical symptoms,shorten the course of treatment and improve prognosis for the early and no risk factory for MDR hospital-acquired pneumonia,which is efficient and security.