头孢类抗菌药物联合阿米卡星治疗白血病感染患者的疗效

Effect of cephalosporins combined with amikacin on treatment of leukemia patients complicated with infections

目的探讨头孢类抗菌药物联合阿米卡星在治疗白血病患者化疗后粒细胞缺乏合并感染中的疗效,以提高临床诊治水平。方法选取2013年3月-2014年3月于医院接受治疗的白血病化疗后粒细胞缺乏合并感染患者92例,随机分为观察组与对照组,各46例,其中对照组给予头孢他啶联合阿米卡星治疗,观察组给予头孢吡肟联合阿米卡星治疗,对比分析两组的临床疗效。结果头孢他啶联合阿米卡星治疗后临床有效率80.43%,头孢吡肟联合阿米卡星治疗后临床有效率82.61%,两组比较差异无统计学意义;患者发生上呼吸道及肺部感染较为常见,两组感染部位比较差异无统计学意义;患者年龄(≥60岁或<60岁)、白血病治疗后缓解指标(完全缓解/部分缓解或无效)、粒细胞缺乏持续时间(≥10d或<10d)与疾病预后存在相关性(P<0.05)。结论头孢他啶联合阿米卡星与头孢吡肟联合阿米卡星治疗白血病化疗后粒细胞缺乏合并感染的临床有效率相当,且安全可靠,值得临床推广应用。

OBJECTIVE To explore the effect of cephalosporins combined with amikacin on treatment of leukemia patients complicated with infections after chemotherapy so as to improve the level of clinical diagnosis and treatment.METHODS A total of 92 agranulocytosis patients who were complicated with infections after the chemotherapy was performed from leukemia from Mar 2013 to Mar 2014 were enrolled in the study and randomly divided into the observation group and the control group,with 46 cases in each;the control group was treated with ceftazidime combined with amikacin,and the observation group was given cefepime combined with amikacin;the clinical efficacy was observed and compared between the two groups.RESULTS The effective rate of clinical treatment with ceftazidime combined with amikacin was 80.43%,and the effective rate of clinical treatment with cefepime combined with amikacin was 82.61%,there was no significant difference between the two groups.The respiratory tract and the lung were the most common infection sites,and there was no significant difference between the two infection sites.The prognosis was correlated with the age（no less than 60 years or less than 60years）recovery indicators after treatment of leukemia（complete recovery,part recovery,or ineffective）or the duration of agranulocytosis（no less than 10 days or less than 10days）（P〈0.05）.CONCLUSIONCeftazidime combined with amikacin and cefepime combined with amikacin can achieve significant clinical effect on treatment of agranulocytosis complicated with infections in the leukemia patients after the chemotherapy,which are safe and reliable and worth to be promoted in the hospital.