糖肽类抗菌药物治疗老年患者肺部感染的临床研究

Clinical effect of glycopeptides antibiotics on treatment of elderly patients with pulmonary infections

目的探究糖肽类抗菌药物治疗老年患者耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染的临床效果及安全性,为临床治疗提供参考依据。方法选取2012年1月-2013年1月住院治疗的112例MRSA肺部感染老年患者,其中73例使用万古霉素治疗,39例使用替考拉宁治疗,比较老年MRSA肺部感染患者两种抗菌药物治疗前后临床症状改善、细菌清除率、不良反应,分析两种抗菌药物在治疗MRSA的疗效。结果使用万古霉素和替考拉宁治疗MRSA后的总有效率比较、细菌清除率比较差异无统计学意义;治疗时间比较差异有统计学意义(t=6.4293,P<0.05);治疗过程中出现胃肠反应、丙氨酸氨基转移酶(ALT)升高、肾毒性等,经对症处理后不良反应均治愈。结论合理使用万古霉素或替考拉宁对于老年MRSA肺部感染患者的治疗效果良好,治疗过程中未出现严重不良反应,安全可靠。

OBJECTIVE To explore the clinical effect and safety of glycopeptides antibiotics on treatment of elderly patients with pulmonary infections due to methicillin‐resistant Staphylococcus aureus （MRSA） so as to provide guidance for clinical treatment .METHODS A total of 112 elderly patients with MRSA pulmonary infections who were hospitalized from Jan 2012 to Jan 2013 were enrolled in the study ,73 patients were treated with vancomycin , and 39 patients were treated with teicoplanin .The improvement of clinical symptoms ,bacterial clearance rates , and incidence of adverse reactions were compared among the elderly patients with MRSA pulmonary infections be‐fore and after the treatment with the two antibiotics ;the effects of the two antibiotics on treatment of MRSA in‐fections were observed .RESULTS There was no significant difference in the total effective rate or bacterial clear‐ance rate after the treatment of MRSA infection with vancomycin and teicoplanin ;there was significant difference in the treatment time （t=6 .4293 ,P〈0 .05） .The patients had the gastrointestinal reactions ,elevated level of ala‐nine aminotransferase （ALT ） ,and renal toxicity during the treatment process ;all the adverse reactions were cured after the symptomatic treatment .CONCLUSION The reasonable use of vancomycin or teicoplanin can achieve significant effect on treatment of the elderly patients with MRSA pulmonary infections ,the severe adverse reac‐tions have not occurred during the treatment process ,and the treatment is safe and reliable .