利奈唑胺与万古霉素对感染性心内膜炎患者细菌清除率及生化指标的影响比较

Comparison of Effects of Linezolid and Vancomycin on Bacterial Clearance and Biochemical Indices in Patients with Infective Endocarditis

目的比较利奈唑胺、万古霉素治疗感染性心内膜炎(IE)患者的效果。方法选取2019年1月—2024年1月山东省公共卫生临床中心收治的100例IE患者为研究对象,按随机数字表法将其分为对照组和观察组,各50例。对照组采用万古霉素治疗,观察组采用利奈唑胺治疗。对比两组的临床疗效、细菌清除率、生化指标及不良反应发生情况。结果观察组治疗总有效率为94.00%,细菌清除率为90.00%,均高于对照组的80.00%、74.00%,组间差异有统计学意义(P<0.05)。治疗后,观察组生化指标中C反应蛋白为(10.19±1.22)mg/L,降钙素原为(0.51±0.11)ng/mL,肿瘤坏死因子-α为(20.29±2.21)ng/L,均低于对照组的(12.24±1.59)mg/L、(0.70±0.19)ng/mL、(24.36±2.58)ng/L,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论与万古霉素相比,利奈唑胺可更好地清除IE患者体内的细菌,控制炎症反应,且不会增加不良反应,存在一定的应用价值,值得临床进行推广应用。

Objective To compare the efficacy of linezolid and vancomycin in the treatment of patients with infective endocarditis(IE).Methods A total of 100 IE patients admitted to the Shandong Public Health Clinical Center from January 2019 to January 2024 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 50 cases in each group.The control group was treated with vancomycin,and the observation group was treated with linezolid.The clinical efficacy,bacterial clearance rate,biochemical indicators and adverse reactions were compared between the two groups.Results The total effective rate and bacterial clearance rate of the observation group were 94.00%and 90.00%,which were higher than 80.00%and 74.00%of the control group,the differences between the two groups were statistically significant(P<0.05).After treatment,the levels of C-reactive protein,procalcitonin and tumor necrosis factor-αin the observation group were(10.19±1.22)mg/L,(0.51±0.11)ng/mL and(20.29±2.21)ng/L,respectively,which were lower than(12.24±1.59)mg/L,(0.70±0.19)ng/mL,(24.36±2.58)ng/L of the control group,and the differences between the groups were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with vancomycin,linezolid can better eliminate bacteria in IE patients,control inflammatory response,and will not increase adverse reactions.Linezolid has certain application value and is worthy of clinical application.