替加环素与亚胺培南西司他丁治疗医院获得性肺炎疗效比较

Comparative Effects Among Different Doses of Tigecycline and Imipenem Cilastatin in Treating Hospital Acquired Pneumonia

目的比较不同剂量替加环素或亚胺培南西司他丁经验性治疗医院获得性肺炎的临床疗效。方法将150例医院获得性肺炎患者随机分为A组、B组和C组。A组患者给予大剂量替加环素治疗,B组患者给予常规剂量替加环素治疗,C组患者给予亚胺培南西司他丁治疗,3组患者均治疗14 d。结果 A组患者总有效率为84.00%,细菌清除率为68.00%;B组患者总有效率为62.00%,细菌清除率为46.00%;C组患者总有效率为66.00%,细菌清除率为40.00%。A组患者之指标均高于B组和C组(P<0.05)。治疗3 d及7 d时,A组患者白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素6(IL-6)及降钙素原(PCT)均低于B组和C组(P<0.05)。治疗3 d时,B组和C组患者感染性指标比较,差异无显著性(P>0.05);治疗7 d时,B组患者WBC及CRP低于C组患者(P<0.05)。A组、B组和C组患者不良反应发生率分别为14.00%,8.00%和10.00%,无显著性差异(P>0.05)。结论与常规剂量替加环素或亚胺培南西司他丁相比,大剂量替加环素治疗医院获得性肺炎临床疗效更好,且不良反应无明显增加。

Objective To compare the clinical efficacy of diftrent doses of tigecycline and imipenem cilastatin in the treatment of hos-pital acquired pneumonia（HAP）. Methods Totally 150 patients with HAP were randomly divided into group A,B and C. The patientsin group A were treated with high dose of tigecycline,the patients in group B were given the routine dose of tigecycline,and the group Cwas treated with imipenem celastatin. The three groups were treated for 14 d. Results In group A, the total eftctive rate was84. 00% ,the bacterial clearance rate was 68.00%. In group B,the total eftctive rate was 62.00% ,the bacterial clearance rate was46. 00%. In group C,the total eftctive rate was 66.00% ,the bacterial clearance rate was 40.00%.The above two indexes in group Awere higher than those in group B and group C（P 〈 0.05）.After 3,7 d of treatment,the levels of WBC,CRP,IL-6 and PCT ingroup A were lower than those in group B and group C（P 〈 0.05）,after 3 d of treatment,there was no significant diftrence in theinfection indexes between the group B and group C（P 〉 0.05）,after 7 d of treatment,the levels of WBC and CRP in group B werelower than those in group C（P 〈 0. 05）. The incidence rates of adverse reactions in group A,B and C were 14. 00% ,8.00% and10. 00% ,respectively,and there were no significant differences（P 〉 0.05）. Conclusion Compared with routine dose of tigecycline orimipenem cilastatin,the efficacy of high dose of tigecycline in the treatment of HAP is better,and there is no significant increase inadverse reactions.