去甲万古霉素治疗重症患者肺部耐甲氧西林金黄色葡萄球菌感染的临床研究

Clinical study of norvancomycin in the treatment of lung infections of critical patients caused by ethicillin-resistant Staphylococcus aureus

目的探讨去甲万古霉素治疗重症患者肺部耐甲氧西林金黄色葡萄球菌感染的临床效果,以保证临床治疗的安全性。方法选取2009年3月-2013年3月医院收治的肺部感染耐甲氧西林金黄色葡萄球菌的重症患者110例,随机分为A组53例、B组57例,A组患者给予万古霉素,B组患者给予去甲万古霉素治疗,两组患者治疗14d后对治疗效果进行评价,研究数据采用SPSS13.0软件进行分析。结果患者治疗有效率、细菌完全清除率A组分别为81.13%、84.91%,B组患者分别为82.46%、82.46%,两组比较差异无统计学意义;A组患者咳嗽消失、体温正常、白细胞及C-反应蛋白恢复正常时间分别为(8.53±1.14)、(7.12±0.95)、(9.98±1.20)d及(11.84±1.65)d,B组患者分别为(6.35±0.58)、(5.30±0.47)、(7.69±0.62)d及(9.23±0.56)d,以上指标B组患者明显短于A组,两组比较差异有统计学意义(P<0.05)。结论对耐甲氧西林金黄色葡萄球菌肺部感染的重症患者实施去甲万古霉素治疗与使用万古霉素治疗相比,治疗效果差异不大,但对治疗时间有一定的影响。

OBJECTIVE To investigate the clinical effect of norvancomycin in the treatment of patients with severe methicillin‐resistant Staphylococcus aureus lung infections so as to ensure the safety of clinical treatment . METHODS Totally 110 cases of patients with severe methicillin‐resistant S .aureus pulmonary infections were se‐lected randomly from Mar .2009 to Mar .2013 .They were randomly divided into two groups .Group A had 53 ca‐ses and the other 57 cases were in Group B .Group A was treated with vancomycin while group B was treated with norvancomycin .The clinical effect was evaluated after 14 days .All data were statistically analyzed by SPSS 13 .0 software .RESULTS The cure rate and complete bacteria removal rate in group A were 81 .13% and 84 .91% in group B ,the numbers were 82 .46% and 82 .46% .The comparison showed no significant difference .The cough disappeared time ,normal temperature time ,and leukocyte CRP （slow‐reactive protein） recovery time were （8 .53 ± 1 .14） ,（7 .12 ± 0 .95） ,（9 .98 ± 1 .20） d and （11 .84 ± 1 .65） d in group A ,and in group B ,they were （6 .35 ± 0 .58） ,（5 .30 ± 0 .47） ,（7 .69 ± 0 .62） d and （9 .23 ± 0 .56） d .Indicators in group B were significantly shorter than those in group A .The difference was significant （P〈0 .05） .CONCLUSION Norvancomycin treatment and vanco‐mycin therapy have similar clinical effect in the treatment of patients with severe lung infections caused by methi‐cillin‐resistant S .aureus ,but they do impact the treatment time .