【摘要】 目的比较替加环素联合治疗对泛耐药鲍曼不动杆菌感染(PDRAB)的疗效差异,了解联合治疗的临床疗效和安全性。方法收集2011年1月至2014年12月广州市胸科医院重症监护病房(ICU)36例肺部泛耐药鲍曼不动杆菌的感染病例,根据替加环素联合使用情况分为对照组(替加环素,n=12)和观察A组(替加环素+亚胺培南,n=12)、观察B组(替加环素+头孢哌酮舒巴坦,n=12)。分别记录急性生理与慢性健康评分,一般生命体征、基础疾病、用药前后各种临床参数(血常规、肝肾功能、呼吸道症状、体征、影像学改变)及不良反应发生的情况,比较和分析替加环素联合治疗的临床疗效差异。结果观察组A和B的治愈率分别为25.0%、58.3%,高于对照组的16.7%;观察组A和B的有效率分别为41.7%、83.3%,高于对照组的33.3%;观察组A和B的细菌清除率分别为58.3%、83.4%,高于对照组的25.0%,差异有统计学意义(P<0.05)。观察组A和B病死率分别为25.0%,22.2%,低于对照组的33.3%,差异无统计学意义(P>0.05)。药物的主要不良反应表现为胃肠道反应,发生率均为25.0%。结论替加环素联合治疗对PDRAB的临床疗效均优于单一使用替加环素,主要的不良反应为恶心、呕吐和腹泻。更多还原

【Abstract】 Objective To study the efficacies and safety of the combination therapy for the treatment of the pan resistant Acinetobacter baumannii(PDRAB) infection. Methods 36 patients with pulmonary pan resistant pan resistant Acinetobacter baumannii infection were selected in our hospital from January 2011 to December 2014 for the study.According to tigecycline combined with use, patients were divided into control group(for the cycloaddition, n =12) and observation group(group A, tegafur ring elements with imipenem plus, n =12; group B, tegafur ring +cefoperazone and sulbactam,n=12). Vital signs and underlying diseases,before and after treatment and adverse reactions of various clinical parameters(blood, liver and kidney function and respiratory symptoms, signs, imaging changes) were recorded. Results The cure rate, effective rate and the bacterial clearance rate of observation group(A / B) were 25% / 58.3%, 41.7% /83.3% and 58.3% / 83.4%, respectively, and were higher than those of control group(16.7%, 33.3% and 25%,respectively). The difference was not statistically significant(P >0.05). The main adverse reaction was gastrointestinal reaction, with an incidence rate of 25%. Conclusions The differences of cure rate, effective rate and PDRAB clearance rate were statistically significant between the observation groups and control group, but the difference in mortality rate was not significant. The main adverse reactions were nausea, vomiting, and diarrhea.更多还原