【作者】 罗琼；

【导师】 刘升明；

【作者基本信息】 暨南大学 ， 内科学， 2010， 硕士

【摘要】 目的：评价左氧氟沙星与阿奇霉素序贯疗法治疗社区获得性肺炎(CAP)的临床疗效和安全性。方法：选取2008年12月-2009年10月广西壮族自治区梧州市工人医院呼吸内科治疗的符合中华医学会呼吸分会2006年制订的《社区获得性肺炎诊断和治疗指南》诊断标准的住院及门诊CAP患者112例,从中筛选符合纳入标准的可评价病例91例,男54例,女37例；年龄19-68岁,平均54.9±12.8岁；各组完成临床研究达到临床疗效分析的总病例数为左氧氟沙星组45例、阿奇霉素组46例。每组受试者的干预方法如下：左氧氟沙星组：将左氧氟沙星注射剂0.4g,溶于0.9%氯化钠500mL静脉滴注,1次/d；治疗3-5天达到转换标准后,改用左氧氟沙星胶囊0.4g,1次/d,口服序贯治疗,5-7天停药。阿奇霉素组：将阿奇霉素0.5g溶于0.9%氯化钠500m1中静脉滴注,1次/d；治疗3-5天达到转换标准后,改用阿奇霉素片剂0.5g,1次/d,口服序贯治疗,5-7天停药。两组疗程为8-12天。观察两组治疗前后的临床疗效及安全性。结果：1.左氧氟沙星组与阿奇霉素组的有效率分别为93.3%和83.3%,痊愈率分别为82.2%和67.4%,差异均有统计学意义(p<0.05)。2.左氧氟沙星组与阿奇霉素组的细菌清除率分别为95.6%和79.2%,差异有统计学意义(p<0.05)。3.左氧氟沙星组与阿奇霉素组的不良反应发生率分别为11.1%和10.9%,差异无统计学意义(p>0.05)。结论：左氧氟沙星序贯疗法治疗CAP的治愈率和细菌清除率均优于阿奇霉素。二者均有良好的安全性。更多还原

【Abstract】 Objective:To evaluate the clinical efficacy and safety of sequential therapy with azithromycin and levofloxacin in treatment of community-acquired pneumonia (CAP).Methods:91 patients with community-acquired pneumonia were divided randomly into the levofloxacin group (45 cases) and azithromycin group (46 cases). The levofloxacin group were treated with levofloxacin 0.4g intravenously once a day for 3～5days, and sequentially changed to oral administration for 5～7days. The azithromycin group were treated with azithromycin 0.5g intravenously once a day for 3～5days, and sequentially changed to oral administration for 5-7days.In both groups the observation of curative effects and safety were conducted.Results:The curative rate of levofloxacin group and azithromycin group were 82.2% and 67.4% respectively, and the differences between two groups were statistical significance (p<0.05). The effective rate of levofloxacin group and azithromycin group were 93.3% and 83.3% respectively, and the differences between two groups were statistical significance (p<0.05). The bacterial eradication rate of levofloxacin group and azithromycin group were 95.6% and 79.2% respectively, and the differences between two groups were statistical significance (p<0.05). The incidence of drug adverse reaction of levofloxacin group and azithromycin group were 11.1% and 10.9% respectively, and there were no significant differences in results between the two groups of treatment (p>0.05)Conclusions:Sequential therapy of levofloxacin has better curative rate and bacterial eradication rate than that of azithromycin in treatment of CAP. Levofloxacin and azithromycin are safety.更多还原