2018 年第 3 期 第 13 卷

大剂量替加环素治疗多重耐药菌引起的呼吸机相关性肺炎的临床效果

Clinical effect of high dose tigecycline on ventilator associated pneumonia caused by multi-drug resistant bacteria

作者：臧会玲王生池程慧

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单位：050011石家庄市第一医院重症医学科

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• 摘要：

• 目的    观察大剂量替加环素治疗多重耐药菌（MDR）引起的呼吸机相关性肺炎（VAP）的临床效果。方法    收集石家庄市第一医院重症医学科2011年6月至2016年4月21例应用大剂量替加环素治疗及28例应用美罗培南治疗的MDR引起的VAP患者的临床资料进行比较分析。对 2组的临床疗效、细菌清除率、抗菌药物使用时间、住院时间及相关不良反应进行评价。结果    替加环素组治疗有效率及细菌清除率高于美罗培南组［76.2%（16/21）比35.7%（10/28）、57.1%(12/21)比32.1%（9/28）］，差异均有统计学意义（P<0.01或P<0.05）。替加环素组抗菌药物用药时间和住院时间短于美罗培南组［（12±3）d比（14±3）d、（15±4）d比（21±5）d］，差异均有统计学意义（均P<0.01）。2组均未出现明显不良反应。结论    应用大剂量替加环素治疗MDR引起的VAP具有良好的临床效果及安全性。

• Objective    To observe the clinical effect of high dose tigecycline on ventilator associated pneumonia(VAP) caused by multi-drug resistant(MDR) bacteria. Methods    Records of 21 MDR VAP patients treated by high dose tigecycline and 28 MDR VAP patients treated by meropenem admitted in the First Hospital of Shijiazhuang from June 2011 to April 2016 were reviewed. Clinical efficacy, bacterial clearance rate, antibacterial drug use time, hospital stay time and adverse reactions were analyzed. Results    Therapeutic effective rate and bacterial clearance rate in tigecycline group were significantly higher than those in meropenem group［76.2%（16/21） vs 35.7%（10/28）, 57.1%(12/21) vs 32.1%（9/28）］(P<0.01 or P<0.05). Antibacterial drug use time and hospital stay time in tigecycline group were significantly shorter than those in meropenem group［（12±3）d vs （14±3）d, （15±4）d vs （21±5）d］(P<0.01). No obvious adverse reaction occurred in both groups. Conclusion    High dose tigecycline has good efficacy and safety in treatment of MDR VAP.