【摘要】 目的 研究严重脓毒症合并急性肾损伤(AKI)患者抗感染时美罗培南剂量选择方案。方法 按照入组标准,把住院患者随机分为A组和B组。A组患者选择抗生素剂量时,参照肌酐清除率,根据药物说明书上建议,严格按照肌酐清除率调整抗生素剂量选择,均为不同程度地减量使用。B组患者选择抗生素剂量时,不参照肌酐清除率,按照药物说明书上建议的最高剂量,即足量使用抗生素。对比研究两组不同AKI分期患者肾功能恢复至正常的比例及所用时间。结果A组和B组患者肾功能恢复至正常所用时间分别为11.7 d和7.9 d。A组和B组AKI 1期患者肾功能正常转归率分别为75.4%和95.1%。A组和B组AKI 2期患者肾功能正常转归率分别为57.8%和76.5%。两组患者肾功能恢复至正常所用时间及两组AKI 1~2期患者肾功能正常转归率比较差异有统计学意义。结论 对严重脓毒症合并AKI患者,足量使用美罗培南没有恶化肾功能,与按照肌酐清除率来选择美罗培南剂量比较,患者肾功能恢复至正常的时间缩短,比例增加。更多还原

【Abstract】 Objective To study the meropenem dose plan in patients with severe sepsis complicated by acute kidney injury(AKI).Methods All the cases which satisfied the inclusion criteria were randomly divided into A group and B group.We chose the antibiotic doses in patients of group A according to creatinine clearance.And,we chose the adequate dose plan of antibiotics in group B regardless of creatinine clearance.We did an investigation in two groups to compare the time and ratio of each group patients,whose renal function recovery to normal.Results The patients in group A spend 11.7 days recovering their renal function to normal.The patients in group B spend 7.9 days recovering their renal function to normal.The difference of the time between two groups has statistical significance.The ratio of the patients during AKI one stage in group A,whose renal function recovery to normal,was 75.4%.The ratio of the patients during AKI one stage in group B,whose renal function recovery to normal,was95.1%.The ratio of the patients during AKI two stage in group A,whose renal function recovery to normal,was 57.8%.The ratio of the patients during AKI two stage in group B,whose renal function recovery to normal,was 76.5%.The difference of the ratio between two groups has statistical significance.Conclusion Compared with the meropenem dose plan according to creatinine clearance,shorter time and bigger ratio exist in patients with severe sepsis complicated by AKI,who are given adequate dose of meropenem and whose renal function recovery to normal.更多还原