比阿培南治疗高龄老年患者呼吸系统感染的分析

Analysis of Biapenem for the treatment of respiratory infections in very elderly patients

目的分析比阿培南在高龄老年患者(≥85岁)呼吸系统感染中的疗效和安全性,为合理使用比阿培南提供依据。方法对2016年1月至2017年12月入住北京医院接受比阿培南治疗并完成实验室检查的高龄感染患者进行回顾性研究。结果共纳入194例患者,年龄85~97(88.5±3.1)岁。感染治疗的临床总有效率为66.5%(129/194)。Logistic回归分析显示,血清尿素氮(BUN)≥8.2 mmol/L(OR=2.404,95%CI:1.425~4.065,P=0.001)和比阿培南单药治疗(OR=1.995,95%CI:1.175~3.386,P=0.006)是治疗失败的独立危险因素,而患者原发疾病类型、体温、之前用药情况、丙氨酸氨基转移酶、天冬氨酸氨基转移酶等指标与临床治疗结果无明显相关性。此外,比阿培南治疗前BUN为(8.6±5.1)mmol/L,治疗后升至(10.3±9.8)mmol/L(t=-3.362、P=0.001)。安全性方面,有11.9%(23/194)的患者出现药物不良反应,均为轻度或中度。结论比阿培南可安全有效地应用于高龄老年患者呼吸系统感染的治疗,建议治疗期间监测BUN水平。

Objective To evaluate the efficacy and safety of Biapenem in very elderly patients(≥85 years old)with respiratory infections,and to provide a basis for rational use of Biapenem.Methods A retrospective study was conducted on patients≥85 years old,who had received Biapenem and undergone relevant laboratory tests from January 2016 to December 2017.Results A total of 194 patients,with an average age of(88.5±3.1)years were enrolled.The rate of clinical effectiveness for infection treatment was 66.5%(129/194).Logistic regression analysis showed that blood urea nitrogen(BUN)≥8.2 mmol/L(OR=2.404,95%CI:1.425-4.065,P=0.001)and Biapenem monotherapy(OR=1.995,95%CI:1.175-3.386,P=0.006)were independent risk factors for treatment failure,while other factors,such as underlying diseases,body temperature,previous drug use,alanine aminotransferase levels and aspartate aminotransferase levels,showed no clear association with clinical outcomes.BUN showed significant elevations from pretreatment(8.6±5.1)mmol/L to post-treatment(10.3±9.8)mmol/L(t=-3.362,P=0.001).Adverse drug reactions were observed in 11.9%(23/194)patients,and all these were mild or intermediate.Conclusions Biapenem is efficacious and safe when used for the treatment of respiratory infections in very elderly patients,and BUN level monitoring during treatment is recommended.