亚胺培南西司他丁钠与美罗培南在重症监护病房多重耐药菌感染中的临床疗效对比

Effect Contrasts of Imipenem Cilastatin Sodium and Meropenem in the Treatment of Multi-Drug Resistant Bacterial Infection in Intensive Care Unit

目的 探讨亚胺培南西司他丁钠与美罗培南在重症监护病房(ICU)多重耐药菌感染中的临床疗效。方法 回顾性分析2020年10月至2021年10月80例焦作市人民医院ICU多重耐药菌感染患者临床资料,其中有40例患者接受亚胺培南西司他丁钠静滴治疗(参照组),另外40例患者接受美罗培南静滴治疗(试验组),比较两组疗效、实验室指标、炎症因子水平、病情严重程度、恢复情况及不良反应。结果 试验组治疗有效率(95.00%)高于参照组(80.00%),差异有统计学意义(P <0.05)。试验组用药后肌酐(Scr)、尿素氮(BUN)、丙氨酸氨基转移酶(ALT)水平高于参照组,其内毒素(ET)含量明显低于参照组,差异有统计学意义(P <0.05)。试验组用药后超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)及降钙素原(PCT)含量均低于参照组,差异有统计学意义(P <0.05)。试验组用药后急性生理及慢性健康状况评分系统(APACHE)Ⅱ评分低于参照组,其体温复常及ICU治疗时长显著短于参照组,差异有统计学意义(P <0.05)。试验组不良反应发生率(2.50%)低于参照组(17.50%),差异有统计学意义(P <0.05)。结论 针对ICU多重耐药菌感染,美罗培南疗效优于亚胺培南西司他丁钠,可显著改善患者实验室指标,降低其机体炎症因子水平,促使病情快速改善,且不良反应较少。

Objective To discuss the clinical efficacy of imipenem cilastatin sodium and meropenem in intensive care unit(ICU)patients with multi-drug resistant organism infections.Methods The clinical data of 80 patients with multi-drug resistant bacterial infection in ICU of Jiaozuo People's Hospital from October 2020 to October 2021 were retrospectively analyzed,40 cases of taking the imipenem cilastatin sodium intravenous drip were set as reference group,40 cases of taking the meropenem intravenous drip were set as experimental group.The treatment effects,laboratory indexes,inflammatory factors,disease severity,patient’s recovery conditions and adverse reactions were compared.Results The total effective rate in the experimental group was higher than reference group,with significant difference(95.00%vs.80.00%,P<0.05);After medication,serum creatinine(Scr),blood urea nitrogen(BUN)and alanine aminotransferase(ALT)levels in the experimental group were higher than reference group,the endotoxin(ET)content was lower than reference group,with significant differences(P<0.05);After medication,the contents of hypersensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and procalcitonin(PCT)in the experimental group were lower than those in the reference group,and the differences were statistically significant(P<0.05);After medication,the acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores in the experimental group were lower than reference group,the body temperature recovery and ICU treatment time were shorter than reference group,with significant differences(P<0.05);The adverse drug rate in the experimental group was lower than reference group,with significant difference(2.50%vs 17.50%,P<0.05).Conclusion Meropenem is superior to imipenem cilastatin sodium in the treatment of multi-drug resistant bacterial infection in ICU.Meropenem can significantly improve the laboratory indexes of patients,reduce the levels of inflammatory factors,promote the rapid improvement of the condition,and has fewer adverse reactions.