采用利奈唑胺治疗肺结核合并重症肺炎的临床疗效及安全性

The clinical efficacy and safety of pulmonary tuberculosis complicated with severe pneumonia treated by linezolid

目的探讨利奈唑胺治疗肺结核合并重症肺炎的临床疗效及安全性。方法对我院2010年3月至2012年9月收治并经过临床确诊的肺结核合并重症肺炎患者50例进行回顾性分析,总结利奈唑胺的疗效,以及比较白细胞数、中性粒细胞数、C反应蛋白、红细胞沉降率、血小板、血肌酐在治疗前后的变化。计数资料应用配对t检验,P<0.05为差异有统计学意义。结果采用利奈唑胺治疗的肺结核合并重症肺炎患者50例中,细菌消除率和临床总有效率均为82.0%(41/50),白细胞数、中性粒细胞数、C反应蛋白、红细胞沉降率在治疗前分别为(14.52±6.88)×109/L、(12.44±7.01)×109/L、(112.28±82.59)μg/L、(66.28±37.71)mm/1h;治疗后分别为(9.94±3.43)×109/L、(7.64±3.46)×109/L、(57.19±59.23)μg/L、(50.56±27.15)mm/1h。治疗前后比较,差异有统计学意义,t值分别为4.214、4.345、3.163、2.098,P值均<0.05。血小板治疗前为(306.54±150.94)×109/L,治疗后为(259.18±140.39)×109/L,治疗前后比较,t=1.625,P=0.107;差异无统计学意义。血肌酐治疗前为(104.88±118.54)μmol/L,治疗后(118.15±122.18)μmol/L,t=-0.535,P=0.594;差异无统计学意义。结论利奈唑胺作为治疗肺结核合并重症肺炎的用药是安全有效的,可作为经验性用药。

Objective To study the clinical efficacy and safety of pulmonary tuberculosis complicated with severe pneumonia treated by linezolid.Methods Fifty cases of patients with pulmonary tuberculosis complicated with severe pneumonia,who were admitted to our hospital from March,2010 to September,2012,diagnosed by clinical data were retrospectively analyzed,in which the efficacy by linezolid was summarized and the values in leukocyte number,neutrophil count,C-reactive protein,erythrocyte sedimentation rate,platelets and serum creatinine were compared between before and after treatment.The paired t test was used for analysis of the enumeration data,in which P0.05 was considered statistically significance.Results In 50 patients with pulmonary tuberculosis complicated with severe pneumonia treated by linezolid,both the bacteria elimination rate and clinical cure rates were 82.0%（41/50）.Their leukocyte number,neutrophil count,C-reactive protein,erythrocyte sedimentation before treatment were（14.52±6.88）×10^9/L,（12.44±7.01）×10^9/L,（112.28±82.59）μg/L and（66.28±37.71）mm/1 h,respectively before treatment and were（9.94±3.43）×10^9/L,（7.64±3.46）×10^9/L,（57.19±59.23）μg/L and（50.56±27.15）mm/1 h,respectively after treatment.There were significant differences between before and after treatment,in which t values were 4.214,4.345,3.163 and 2.098 and all P values were less than 0.05.The platelets count before treatment was（306.54±150.94）×10^9/L and after treatment was（259.18±140.39）×10^9/L,in which t value was 1.625,P value was 0.107;The blood creatinine concentrations were（104.88±118.54）μmol/L before treatment,（118.15±122.18）μmol/L after treatment,in which t value was-0.535,P value 0.594.No statistical differences were found between before and after treatment in platelets count and blood creatinine concentrations（all P values 0.05）.Conclusion It is safe and effective for the patients with pulmonary tuberculosis complicated with severe pneumonia treated by linezolid,which can be used as empirical medication.