【摘要】 目的观察比较利奈唑胺和万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)呼吸机相关性肺炎(VAP)的临床效果和不良反应。方法将88例MRSA所致VAP患者随机分为2组,治疗组和对照组各44例。治疗组采用利奈唑胺治疗,对照组采用万古霉素治疗。2组疗程均为14 d,观察2组的临床疗效和不良反应。结果MRSA清除率治疗组为79.55%,对照组为56.82%;治疗组总有效率为74.00%,对照组为52.00%,2组比较,治疗组清除率、总有效率均优于对照组(P<0.05)。不良反应发生率治疗组为11.36%,对照组为13.64%,2组比较差异无统计学意义(P>0.05)。结论利奈唑胺对MRSA所致VAP有较好的临床疗效,毒副作用与万古霉素相当。更多还原

【Abstract】 Objective To explore the efficacy and safety of linezolid and vancomycin in the treatment of ventilator-associated pneumonia(VAP)caused by meticillin-resistant Staphylococcus aureus(MRSA)so as to guide the clinical diagnosis and treatment. Methods A total of 68cases of patients with VAP caused by MRSA were randomly divided into the linezolid group(n=34)and the vancomycin group(n=34).All the treatment courses were 7-14days.The clinical effect,bacterial clearance rate,inflammatory reaction and side effect were observed and compared. Results The bacterial clearance rate and the total effective rate of the linezolid group were respectively 79.55% and 64.7%,significantly higher than74.00% and 52.00% of the vancomycin group,the difference was statistically significan(tP<0.05).The levels of white blood cell,C-reactive protein and procalcitonin in both groups were significantly decreased compared with those before the treatment(P<0.05),while those indicators were decreased more remarkably in the linezolid group than in the vancomycin group,the difference was statistically significant(P<0.05).The incidence rate of the adverse reaction was11.36% in the linezolid group and13.64% in the vancomycin group,the difference was not statistically significant.Conclusion Linezolid is more effective than vancomycin in the treatment of VAP caused by MRSA,it can remarkably raise the bacterial clearance rate and reduce the pulmonary inflammatory reactions,with less adverse reactions caused.更多还原