替加环素早期应用对不同类型重症肺部感染的临床疗效

Clinical efficacy of early application of tigecycline in different types severe pulmonary infections

目的探讨替加环素早期应用对不同类型重症肺部感染的临床疗效。方法选取2016年10月至2018年10月该院重症肺部感染患者100例,其中常规治疗48h效果不佳换用替加环素者48例(早期组),据药敏选药者52例(常规组)。比较2组间感染、预后指标及不良反应情况。早期组按疾病进一步分为慢性阻塞性肺疾病急性加重合并肺部感染组(COPD组)、间质性肺疾病合并肺部感染组(ILD组)、肺部感染所致急性呼吸窘迫综合征组(ARDS组)等不同亚组,比较亚组间感染及预后指标。结果与常规组比较,早期组各项炎症指标下降幅度更大,差异均有统计学意义(P<0.05);预后指标中,2组间出RICU率比较差异无统计学意义(P>0.05),其余指标早期组均优于常规组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。亚组间,COPD组炎症及预后指标优于ILD组和ARDS组,差异均有统计学意义(P<0.05)。结论早期替加环素治疗重症肺部感染可避免治疗时机延误,改善预后,对COPD合并肺部感染疗效更显著。

ObjectiveTo investigate the clinical efficacy of early application of tigecycline in different types of severe pulmonary infection.Methods100 patients with severe pulmonary infection in the hospital from October 2016 to October 2018 were selected.Among them,48 patients who had poor results after routine treatment for 48 h were switched to tigecycline as the early group.According to the drug sensitivity results,52 patients were selected as the regular group.The infection,prognosis indicators and adverse reactions between the two groups were compared.In the early group,the disease was divided into different subgroups:Acute exacerbation of chronic obstructive pulmonary disease with pulmonary infection(COPD group),Interstitial lung disease with pulmonary infection group(ILD group),Acute respiratory distress syndrome group caused by pulmonary infection(ARDS group).Infection and prognostic indicators between subgroups were compared.ResultsCompared with the conventional group,the inflammation index of the early group decreased more,and the difference was statistically significant(P<0.05).Among the prognostic indicators,there was no significant difference in the RICU rate between the two groups(P>0.05),and the other groups were better than the conventional group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).In the subgroup,the inflammation and prognosis of COPD group were better than those of ILD group and ARDS group,and the difference was statistically significant(P<0.05).ConclusionEarly treatment with tigecycline in severe pulmonary infection can avoid delays in treatment,improve prognosis,and have a more pronounced effect on COPD with pulmonary infection.