3种β-内酰胺类抗生素对老年糖尿病患者泌尿系感染的疗效比较

Comparison of clinical effect of 3 kinds of β-lactam antibiotics on urinary tract infection in the elderly diabetic patients

目的:比较应用3种β-内酰胺类抗生素对老年糖尿病患者泌尿系感染的临床疗效差异。方法:前瞻性选择120例罹患泌尿系感染的老年糖尿病患者,依据随机数字法所用β-内酰胺类抗生素不同分为:A组,予以头孢噻肟钠2 g,bid静滴治疗;B组,予以头孢他啶钠2 g,bid静滴治疗;C组,予以头孢替唑钠2 g,bid静滴治疗。3组患者均为40例,疗程均为7 d。治疗后比较3组的治疗有效率、细菌学清除率的差异,并对3组各种不良反应发生率进行比较。随访1月,比较3组患者泌尿系感染再发率差异。结果:3组的总有效率和显效率为A组>C组>B组(P<0.05),而无效率为B组>C组>A组(P<0.05)。3组的细菌学清除率存在A组最佳(P<0.05),而B组与C组无差异(P>0.05)。3组的各种不良反应发生率均无差异(P>0.05)。随访1月,3组患者泌尿系感染再发率为B组>C组>A组(P<0.05)。结论:头孢噻肟钠治疗老年糖尿病患者泌尿系感染的治疗有效率和细菌学清除率最高,且再发率最低。

Objective： To compare the clinical effect of 3 kinds of β-1actam antibiotics on urinary tract infection （UTI） in the elderly diabetic patients. Methods： 120 elderly diabetic patients with UTI were divided into three groups by random number table, group A （received the antibiotic therapy of cefotaxime sodium 2 g, bid, ivgtt）, group B （received the antibiotic therapy of ceftazidime sodium 2 g, bid, ivgtt） and group C （received the antibiotic therapy of ceftezole sodium 2 g, bid, ivgtt）. Each group included 40 cases and the course of treatment in three groups was 7 days. The indexes of therapeutic efficiency ratio and the bacterial clearance ratio were compared among three groups. The occurrences of all kinds of adverse reaction were compared among three groups. The recurrence rates of UTI were compared among three groups with one-month follow-up. Results： The indexes of total effectiveness rate and significant efficiency rate in three groups were group A 〉 group C 〉 group B （P 〈 0.05）, inefficiency rate in three groups were group B 〉 group C 〉 group A （P 〈 0.05）. The indexes of bacterial clearance ratio were best in group A （P 〈 0.05）, but there were no different between group B and group C （P 〉 0.05）. The occurrences of all kinds of adverse reaction were no different among three groups （P 〉 0.05）. The recurrence rates of UTI were group B 〉 group C 〉 group A （P 〈 0.05） with one-month follow-up. Conclusion： Among the three agents, cefotaxime sodium treatment got the highest indexes of therapeutic efficiency ratio and the bacterial clearance ratio, and the lowest UTI recurrence rate-.