达托霉素对感染性心内膜炎患者炎症指标及生活质量的影响

Effect of daptomycin on inflammatory markers and quality of life in patients with infective endocarditis

目的探讨达托霉素对感染性心内膜炎患者炎症指标及生活质量的影响。方法本研究所选观察对象为衢州市人民医院2021年1月至2023年9月收治的87例感染性心内膜炎患者,按照两组患者就诊顺序分组,将2021年1月至2022年4月就诊的43例患者纳入对照组,将2022年5月至2023年9月收治的44例患者纳入观察组,对照组在常规治疗基础上予以阿莫西林克拉维酸钾联合依替米星治疗,观察组在常规治疗基础上予以达托霉素治疗,比较两组患者治疗效果、炎症指标、赘生物直径、生存质量及不良反应发生情况。结果在治疗总有效率方面,观察组(95.45%,42/44)相较于对照组(79.06%,34/43)更高(χ^(2)=5.286,P=0.021);观察组治疗后ESR、Hs-CRP、PCT及赘生物直径[分别为(14.31±1.50)mm·h^(-1)、(8.26±1.35)mg·L^(-1)、(0.38±0.10)ng·mL^(-1)、(3.25±0.33)mm]低于对照组[分别为(22.04±1.87)mm·h^(-1)、(12.10±1.67)mg·L^(-1)、(0.45±0.11)ng·mL^(-1)、(3.72±0.39)mm],差异均有统计学意义(t=21.292、11.807、3.107、6.073,均P<0.05);观察组治疗后生理领域、心理领域、社会关系领域及环境领域评分[分别为(75.49±5.54)分、(78.05±5.68)分、(76.10±4.69)分、(72.18±4.26)分]高于对照组[分别为(70.58±4.87)分、(73.53±5.26)分、(73.27±4.53)分、(68.96±4.6)分],差异均有统计学意义(t=8.161、4.765、3.088、3.373,均P<0.05)。在不良反应发生率方面,观察组2.27%(1/44),对照组为9.30%(4/43),组间差异无统计学意义(χ^(2)=0.898,P=0.343)。结论应用达托霉素治疗感染性心内膜炎患者能够改善炎症反应,提高生存质量,且安全性好。

Objective To investigate the effect of daptomycin on inflammatory markers and quality of life in patients with infective endocarditis.Methods A total of 87 patients with infective endocarditis admitted to Quzhou People's Hospital from January 2021 to September 2023 were selected as the research subjects.According to the order of treatment,43 patients treated in the hospital from January 2021 to April 2022 were included in the control group and the other 44 patients treated from May 2022 to September 2023 were included in the observation group.The patients in the control group received amoxicillin-clavulanate potassium combined with etimestin in addition to conventional treatment,while those in the observation group received daptomycin in addition to conventional treatment.The treatment effectiveness,inflammatory indexes,growth diameter,quality of life and adverse reactions were compared between the two groups.Results The total effective rate of the observation group(95.45%,42/44)was higher than that of the control(79.06%,34/43),showing statistically significant difference(χ^(2)=5.286,P=0.021).After treatment,the levels of the ESR,Hs-CRP,PCT and growth diameter were(14.31±1.50)mm·h-1,(8.26±1.35)mg·L^(-1),(0.38±0.10)ng·mL^(-1) and(3.25±0.33)mm in the observation group,and they were significantly lower than those of((22.04±1.87)mm·h-1,(12.10±1.67)mg·L^(-1),(0.45±0.11)ng·mL^(-1) and(3.72±0.39)mm)in the control(t=21.292,11.807,3.107,6.073,all P<0.05).The scores of physiological,psychological,social relations and environmental fields in the observation group were(75.49±5.54)points,(78.05±5.68)points,(76.10±4.69)points and(72.18±4.26)points,which were higher than those of(70.58±4.87)points,(73.53±5.26)points,(73.27±4.53)points and(68.96±4.6)points in the control,demonstrating statistically significant differences(t=8.161,4.765,3.088,3.373,all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(2.27%(1/44)vs 9.30%(4/43),χ^(2)=0.898,P=0.343).Conclusion Applying daptomycin in the treatment of patients with infective endocarditis can improve the inflammatory response and the quality of life in the patients.Meanwhile,it is of high safety.