国产与进口万古霉素在重症病人并发G+球菌感染中的临床效果观察
Clinical application effect of domestic and imported vancomycin in severe patients with G+ coccusinfection
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摘要: 目的:比较国产和进口万古霉素治疗重症病人并发G+球菌感染的临床效果和不良反应。方法:选取40例重症并发G+球菌病人,随机分为国产万古霉素组(A组)和进口万古霉素组(B组),比较2组病人的一般临床资料、万古霉素稳态谷浓度、体温、白细胞(WBC)和肾功能变化,进一步评价7d和28d临床有效率。结果:2组年龄、性别、APACHEⅡ评分、使用万古霉素前的最高体温、WBC、肾功能指标(肌酐、尿素氮和尿量)、原发病、感染部位、联合抗生素种类以及机械通气差异均无统计学意义(P>0.05);A组和B组万古霉素谷浓度分别为(9.3±4.4)μg/mL和(11.9±11.1)μg/mL,在10~20 μg/mL病例数分别为8例和5例,达标率为40%和25%,2组之间差异均无统计学意义(P>0.05);A组和B组在72 h体温和WBC下降两方面差异均无统计学意义(P>0.05);A组和B组分别有3例和2例发生Ⅰ级急性肾损伤,2组病人用药前、用药72 h及停药后肌酐、尿素氮和尿量差异均无统计学意义(P>0.05);A组和B组在7 d和28 d有效病例数及临床有效率,ICU住院时间方面差异无统计学意义(P>0.05)。结论:对于重症并发G+球菌感染病人,国产和进口万古霉素血药浓度水平、临床有效率和肾毒性发生率均相当,疗效肯定。Abstract: Objective:To compare the clinical effects and adverse reactions between domestic and imported vancomycin in the treatment of severe patients with G+ coccus infection.Methods:Forty severe patients with G+ coccus infection in ICU were randomly divided into the domestic vancomycin group(group A) and imported vancomycin group(group B).The clinical data,vancomycin steady-state valley concentration,body temperature,white blood cell and renal function in two groups were recorded,and the clinical effects in two groups were evaluated after 7 and 28 days of treatment.Results:The differences of the age,sex,APACHEⅡ score,highest body temperature before using vancomycin,white blood cell,renal function(including creatinine,urea nitrogen and urine volume),primary disease,location of infection,combination use of antibiotics and mechanical ventilation between two groups were not statistically significant(P>0.05).The steady-state valley concentrations of vancomycin in group A and group B were(9.3±4.4)μg/mL and(11.9±11.1)μg/mL,respectively.At the(10-20)μg/mL of vancomycin,the cases in group A and group B were 8 and 5,respectively,the standard rate was 40% and 25%,respectively,and the difference of which was not statistically significant(P>0.05).There was no statistical significance in the decreasing degree of 72 h body temperature and white blood cell between group A and group B(P>0.05).Three acute kidney injury cases in group A and 2 acute kidney injury cases in group B were found,all 5 cases were type Ⅰ acute kidney injury,and there was no statistical significance in creatinine,urea nitrogen and urine volume between two groups among before medication,72 hours of medication and after withdrawal(P>0.05).There was no statistical significance in the 7 d and 28 d effective number of cases,clinical efficiency and length of stay in ICU between two groups (P>0.05).Conclusions:Among the severe patients with G+ coccusinfection,the level of blood drug concentration of vancomycin,clinical efficiency and nephrotoxicity between domestic and imported vancomycin treatment are sure and similar.
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Key words:
- infection /
- severe case /
- vancomycin /
- blood drugconcentration
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