替加环素治疗化疗后粒细胞缺乏伴发热恶性血液病患者的疗效观察

Efficacy and safety of tegacycline in the treatment of malignancies hematologic patients with granule deficiency with fever

目的:探讨替加环素治疗化疗后粒细胞缺乏伴发热血液病患者的疗效及安全性。方法:选择我院血液科从2014年9月至2018年11月收治的79例恶性血液病经化疗后粒细胞缺乏伴发热的住院感染患者,采用随机平行对照法,对照组设定为更换替加环素(39例)抗感染治疗,观察组设定为初始即联合其它抗菌药物(40例)抗感染治疗,回顾性分析不同组别患者抗感染治疗的临床疗效和药物相关不良反应。结果:79例患者中,17例(21.52%)痊愈,43例(54.43%)感染得到控制,16例(20.25%)无效,3例(3.80%)死亡。观察组和对照组抗菌治疗总有效率分别为77.5%和74.36%,两组总有效率差异无统计学意义(P>0.05)。替加环素主要不良反应为恶心呕吐等消化道症状,耐受性良好。结论:替加环素抗菌活性强、抗菌谱广,具有良好的疗效和安全性,可作为恶性血液病化疗后粒细胞缺乏伴发热患者替补方案或经验治疗的选择。

Objective:To investigate the efficacy and safety of tigecycline in the treatment of in malignancies hematologic patients with granule deficiency with fever.Methods:Seventy-nine patients treated with tigecycline for granule deficiency with fever after chemotherapy in our hospital from September 2014 to November 2018 were selected.The clinical efficacy and adverse drug reactions of patients in the two groups after treatment were retrospectively analyzed using a randomized,parallel controlled trial,with replacement of tigecycline as the control group(39 cases) and the initial combination with other antibacterial agents as the observation group(40 cases).Results:Among the 79 patients enrolled,17 patients were cured(21.52%),43 patients(54.43%) had the infection under control,16 patients(20.25%) were ineffective,and 3 patients(3.80%) died.The total effective rates of the observation group and the control group were 77.5% and 74.36% respectively,and there was no statistically significant difference between the two groups(P>0.05).Main adverse events were nausea and vomiting,but all events were slight.Conclusion:Due to its high antibacterial activity and broad antibacterial spectrum,tigaricycline has good efficacy and safety,and can be used as a supplement or an experienced treatment for patients with granulocyte deficiency with fever after chemotherapy for malignant hematological diseases.