头孢吡肟治疗急性白血病化疗后感染的临床疗效观察

Clinical efficacy of cefepime in treating acute infection after chemotherapy

目的研究不同头孢类抗菌药在治疗急性白血病患者化疗后感染的疗效和不良反应。方法选取急性白血病化疗后感染患者112例为研究对象，通过随机数字表法分为对照组和研究组，每组56例，两组患者均静脉滴注硫酸阿米卡星，对照组患者在此基础上静脉滴注头孢他啶，研究组静脉点注头孢吡肟，两组患者均治疗7 d。观察两组患者的临床疗效，治疗后退热时间，治疗前后 C-反应蛋白（CRP）水平，统计两组患者外周血中性粒细胞（ANA）分布水平和不良反应情况。结果对照组患者的治疗总有效率为83．9％，研究组为94．6％，两组差异有统计学意义（χ^2＝4．92，P ＝0．02）；治疗后研究组患者的 ANC 正常率明显高于对照组（χ^2＝6．62，P ＝0．01）；对照组患者的平均退热时间为（3．9±0．8）d，研究组为（2．6±0．8）d，两组比较差异有统计学意义（t ＝8．44，P ＝0．00）；研究组治疗后 CRP 为（21．18±4．07）mg／L，显著低于对照组（37．27±5．32）mg／L，两组比较差异具有统计学意义（t ＝7．71，P ＝0．00），研究组不良反应发生率为5．3％显著低于对照组的19．6％，两组比较差异具有统计学意义（χ^2＝5．22，P ＝0．02）。结论头孢吡肟治疗急性白血病化疗后感染患者疗效显著，可提高患者中性粒细胞数量，安全性分析不良反应轻微，是一种值得在临床中推广的头孢类药物。

Objective To study the efficacy and adverse reactions of different kinds of antibiotics in the treatment of patients with acute leukemia after chemotherapy.Methods 112 cases with acute leukemia after chemo-therapy and infected were selected as the research subjects,and were randomly divided into the study group and the control group,56 cases in each group,Two groups of patients were intravenously injected amikacin sulfate,control group was intravenously injected ceftazidime and study group was given cefepime,two groups of patients were treated for 7 days.The clinical efficacy,the defervescence time,C -reactive protein （CRP）level,peripheral blood neutro-philic granulocyte （ANA）distribution levels and adverse reactions were observed.Results In the control group,the total effective rate was 83.9%,which of the study group was 94.6%,the difference between the two groups was statis-tically significant （χ^2 =4.92,P =0.02）.The normal rate of ANC in the study group was significantly higher than the control group （χ^2 =6.62,P =0.01）.The average defervescence time of the control group was （3.9 ±0.8）d,which of the study group was （2.6 ±0.8）d,there was significant difference between the two groups （t =8.44,P =0.00）;CRP level of the study group after treatment was （21.18 ±4.07）mg/L,which was significantly lower than （37.27 ± 5.32）mg/L of the control group,with significant difference between the two groups （t =7.71,P =0.00）.The incidence rate of adverse reaction of study group was 5.3%,which was significantly lower than 19.6% in the controlgroup,with significant difference between the two groups （χ^2 =5.22,P =0.02）.Conclusion Cefepime in the treatment of acute leukemia chemotherapy after infection has significant curative effect,can improve patients＇neutral granu-locyte number and adverse reactions are mild,it is worthy of popularization in clinical.