头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效观察_West China Medical Journal

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黄春晖

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Keywords：

头孢吡肟; 头孢他啶; 阿米卡星; 血液肿瘤; 细菌性肺炎

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目的:观察头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效和不良反应。方法:120例入选患者随机分为治疗组和对照组,每组60例,分别接受头孢吡肟联合阿米卡星及头孢他啶联合阿米卡星治疗。其中,头孢吡肟或头孢他啶均为2g加入生理盐水100mL,每日2次,静脉点滴;阿米卡星0.4g,加入生理盐水500mL中,每日1次,静脉点滴,治疗持续一般1～2周。采用卫生部1993年抗菌药物临床研究指导原则进行判断疗效.结果:治疗组与对照组有效率分别为80%、76.7%,细菌清除率分别为91.9%、90.2%。两组比较差异无统计学意义(P gt;0．05)。两组患者共分离出病原菌123株,药敏试验显示对头孢吡肟的敏感率为90.2%,显著高于头孢他啶69.7%,差异有统计学意义(P lt;0．01)。不良反应主要有恶心及皮疹等,均可耐受。发生率分别为5%和11%,两组比较差异无统计学意义(P gt;0．05)。结论:头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效略优于头孢他啶组,体外抗菌活性显著优于头孢他啶组。

Citation： 黄春晖. 头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效观察. West China Medical Journal, 2009, 24(5): 1242-1244. doi: Copy

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1. 张之南.血液病诊断及疗效标准[M].第2版.北京:科学技术出版社,1998:164165.
2. 沈杨,沈睿,陈钰,等.血液肿瘤合并感染病原菌流行病学及耐药性研究[J].中华血液学杂志,2004,25(6):328332.
3. HUGHES W T, ARMSTRONG D, BODEY G P． 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer[J]． Clin Infect Dis,2002,34(6):730751.
4. 中华医学会呼吸病学分会．社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,29(10):651655.
5. JONES R N. Important and emerging βlactamasemediated resistances in hospitalbased pathogens: the Amp C enzyme [J]. Diagn Microbiol Infect Dis,1998,31(3):462463.
6. JONES R N, PFALLER M A, DOERN G V, et al. Antimicrobial activity and spectrum inestigation of eight broadspectrum βlactam drugs: a 1997 surveillance trial in102 medical centers in the United States. Cefepime Study Group[J]. Diagn Microbiol Infect Dis,1998,30(3):215228.
7. WST J, FREI R. Multicenter study of the in vitro activity of cefepime in comparison with five other broad-spectrum antibiotics against clinical isolates of Grampositive and Gramnegative bacteria from hospitalized patients in Switzerland[J]. Clin Microbiol Infect,1999,5(5):262269.
8. 万建华,张静萍,储云卓,等.阿米卡星对产ESBLs大肠埃希菌的体外抗菌活性[J].第四军医大学学报,2004,25(15):13651367.
9. 郑卫.氨基糖甙类抗生素研究新进展[J].国外医学抗生素分册,2005,26(3):101.
10. 陈雪融,姚蓉,梁宗安,等.盐酸头孢吡肟治疗下呼吸道感染和泌尿系感染的多中心随机对照临床研究[J].华西药学杂志,2007,22(4):457458.

West China Medical Journal

头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效观察

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