摘要
目的:观察阿米卡星不同给药方式治疗呼吸机相关性肺炎的疗效和安全性。方法:回顾性收集109例呼吸机相关性肺炎患者资料,按给药方式的不同分为观察组(58例)和对照组(51例)。两组患者均给予注射用头孢曲松钠3.0 g,加入0.9%氯化钠注射液100 ml中,静脉滴注,q12 h。在此基础上,对照组患者给予硫酸阿米卡星注射液7.5 mg/kg,每日1次;观察组患者给予硫酸阿米卡星注射液7.5 mg/kg,加入0.45%氯化钠注射液20 ml,雾化吸入,每日2次。两组疗程均为7 d。观察两组患者治疗前后的临床肺部感染评分(CPIS)、丙氨酸转氨酶(ALT)、血清肌酐(Cr)、氧合指数(Pa O2/Fi O2)、白细胞介素(IL)-10、IL-6、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、治疗后3个月累积死亡率及不良反应发生情况。结果:治疗前,两组患者CPIS评分、ALT、Cr、Pa O2/Fi O2、IL-10、IL-6、CRP、TNF-α比较,差异均无统计学意义(P>0.05)。治疗后,两组患者CPIS评分、TNF-α、IL-6、CRP水平均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);两组患者治疗前后IL-10水平比较差异无统计学意义(P>0.05)。观察组患者Pa O2/Fi O2及对照组ALT、Cr、Pa O2/Fi O2均显著高于同组治疗前,且观察组Pa O2/Fi O2高于对照组,但观察组ALT、Cr均显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗后3个月累积死亡率显著低于对照组,差异有统计学意义(P<0.05)。两组患者治疗期间均未见严重不良反应发生。结论:雾化吸入阿米卡星治疗呼吸机相关肺炎的疗效优于静脉用药,可有效降低患者炎症因子水平和死亡率,且不增加不良反应的发生。
OBJECTIVE： To observe the efficacy and safety of amikacin different administrations in the treatment of ventila- tor-associated pneumonia. METHODS： Data of 109 patients with ventilator-associated pneumonia were divided into observation group （58 cases） and control group （51 cases） based on different administrations. All patients received 3.0 g Ceftriaxone sodium for injection, adding into 100 ml 0.9% Sodium chloride injection, intravenously, once every 12 h. Based on it, control group re- ceived 7.5 mg/kg Amikacin sulfate injection, once a day. Observation group received 7.5 mg/kg Amikacin sulfate injection, adding into 20 ml 0.45% Sodium chloride injection, aerosol inhalation, twice a day. The treatment course for both groups was 7 d. Clinical pulmonary infection score （CPIS）, alanine aminotransferase （ALT）, serum creatinine （Cr）, oxygenation index （PaOJFiO2）, IL-10, IL-6, C-reactive protein （CRP）, tumor necrosis factor （TNF） -α, cumulative mortality after 3 months of treatment and the incidence of adverse reactions before and after treatment in 2 groups were observed. RESULTS.. Before treatment, there were no significant differences in the CPIS score, ALT, Cr, PaO2/FiO2, IL-10, IL-6, CRP and TNF-α levels in 2 groups （P〉0.05）. After treatment, CPIS score, TNF-α, IL-6 and CRP levels in 2 groups were significantly lower than before, observation group was low- er than control group, the difference was statistically significant （P〈0.05）, and there was no significant difference in IL-10 before and after treatment in 2 groups （P〉0.05）. PaOz/FiO2 in observation group and ALT, Cr and PaO2/FiO2 in control group were signif- icantly higher than before, PaO2/FiO2 in observation group was higher than control group, ALT and Cr were significantly lower than control group, the differences were statistically significant （P〈0.05）. The cumulative mortality after 3 months of treatment in observation group was significantly lower than control group, the difference was s
出处
《中国药房》
CAS
北大核心
2016年第27期3780-3782,共3页
China Pharmacy
关键词
呼吸机相关肺炎
阿米卡星
雾化吸入
给药方式
鲍曼不动杆菌
Ventilator-associated pneumonia
Amikacin
Aerosol inhalation
Administration route
Acinetobacter baumannii
