进口万古霉素与国产去甲万古霉素治疗耐甲氧西林金葡球菌下呼吸道感染的对比研究

Comparative effect of vancomycin and norvancomycin on lower respiratory tract infections caused by methicillin-resistant Staphylococcus aureus

目的 探讨万古霉素和去甲万古霉素对耐甲氧西林金黄色葡萄球菌 (MRSA)下呼吸道感染的敏感性、临床疗效和不良反应。方法 对本院呼吸疾病重症监护病房 (RICU)住院的 115例MRSA所致下呼吸道感染患者采用随机配对法分为去甲万古霉素治疗组 (A组 ,68例 )和万古霉素治疗组 (B组 ,47例 ) ,比较两组病人的临床疗效和不良反应发生率。并对MRSA进行药敏分析。结果 两组病人 115株MRSA均对万古霉素和去甲万古霉素敏感 (敏感率 10 0 % ) ,A、B两组临床有效率分别为 80 9%和 78 7% (P >0 0 5 ) ,MRSA清除率分别为 80 9%和 82 9% (P >0 0 5 )。A组有 5例和B组有 3例出现肾功能损害 ,A、B组各有 2例出现皮疹。结论 国产去甲万古霉素对MRSA敏感 ,临床疗效良好 ,与进口万古霉素一致 ,而且不良反应较轻 ,适用于治疗MRSA感染。

Objective To analyse the sensitivity, clinical efficacy and side effect of vancomycin and norvancomycin on lower respiratory tract infections caused by methicillin resistant Staplylococcus aureus (MRSA). Methods 115 cases of MRSA lower respiratory tract infections were divided randomly into norvancomycin-therapy group (A,68 cases)and vancomycin-therapy group (B,47 cases). The sensitivity, clinical efficacy and side effect of the two groups were observed. Results 115 isolates of the groups were sensitive to vancomycin and norvancomycin. The clinical effective rates in the group A and group B were 80.9% and 78.7% respectively ( P >0.05). The clearance rates of MRSA in the group A and group B were 80.9% and 82.9%. Renal damage had happen to 5 cases in group A and 3 cases in group B; while 2 cases in group A and 2 cases in group B had skin rash. Conclusion Norvancomycin was as the same as vancomycin in respect of sensitivity, clinical efficacy , and side effect against MRSA. Norvancomycin should be choosed for the treatment of MRSA infections.