替加环素对血液病患者肺部感染的疗效分析

Efficacy of tigecycline in the treatment of patients with hematologic diseases and pulmonary infection

目的 ：探讨替加环素作为二线方案治疗血液病患者肺部感染的疗效及安全性。方法 ：在血液病患者发生肺部感染时,使用一线抗感染药物治疗不能控制,病原学提示多重耐药或是临床高度怀疑多重耐药的情况下,经验性使用替加环素为二线治疗方案,并进行联合抗感染治疗。对临床资料进行分析,评价其治疗效果和不良反应。结果：50例患者中痊愈11例,显效11例,有效16例,无效8例;治愈率22%,总有效率76%。替加环素起效时间2~6 d（平均3.2 d）。死亡7例,其中有5例患者死亡与感染未控制有关,2例与感染无关。使用过程中患者最常出现的不良反应为恶性、呕吐、腹泻,一般经对症处理后均能耐受。结论：本研究结果显示,以替加环素为基础的经验性二线抗感染治疗方案在血液病肺部感染中获得较好疗效,且患者耐受良好,安全性较高。

Objective：To investigate the efficacy and safety of tigecycline as a second-line therapy in the treatment of pulmonary infections in patients with hematologic diseases. Methods：When pulmonary infection can not be controlled in patients with hematologic diseases by first-line anti-infective therapy,especially existing etiological evidence or clinical suspicion of multi-drug resistant infection,we should consider tigecycline as an experiential second-line therapy in combination with other anti-infection antibiotics. The clinical data were analyzed to evaluate the efficacy and safety of this regimen. Results：A total of 50 cases of patients with hematologic diseases and pulmonary infection received this regimen. Eleven cases were cured,11 cases were in partial remission,16 cases were partial effection,and 8 cases were ineffective. The cure rate was 22% and the total effective rate was 76%.The onset time was 2-6 days（average 3.2 days）. Seven cases died,and 5 cases attributed to uncontrolled infection. The most common adverse reactions in patients were vomit and diarrhea. The side effects were generally well-tolerated after symptomatic treatment.Conclusion：According to this study,the regimen of tigecycline as an experiential second-line therapy is effective and well-tolerated.