• 山東省濟(jì)寧醫(yī)學(xué)院附屬湖西醫(yī)院,山東單縣 273700;

目的:觀察頭孢吡肟聯(lián)合阿米卡星治療血液腫瘤粒缺期細(xì)菌性肺炎的療效和不良反應(yīng)。方法:120例入選患者隨機(jī)分為治療組和對(duì)照組,每組60例,分別接受頭孢吡肟聯(lián)合阿米卡星及頭孢他啶聯(lián)合阿米卡星治療。其中,頭孢吡肟或頭孢他啶均為2g加入生理鹽水100mL,每日2次,靜脈點(diǎn)滴;阿米卡星0.4g,加入生理鹽水500mL中,每日1次,靜脈點(diǎn)滴,治療持續(xù)一般1～2周。采用衛(wèi)生部1993年抗菌藥物臨床研究指導(dǎo)原則進(jìn)行判斷療效.結(jié)果:治療組與對(duì)照組有效率分別為80%、76.7%,細(xì)菌清除率分別為91.9%、90.2%。兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P gt;0．05)。兩組患者共分離出病原菌123株,藥敏試驗(yàn)顯示對(duì)頭孢吡肟的敏感率為90.2%,顯著高于頭孢他啶69.7%,差異有統(tǒng)計(jì)學(xué)意義(P lt;0．01)。不良反應(yīng)主要有惡心及皮疹等,均可耐受。發(fā)生率分別為5%和11%,兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P gt;0．05)。結(jié)論:頭孢吡肟聯(lián)合阿米卡星治療血液腫瘤粒缺期細(xì)菌性肺炎的療效略優(yōu)于頭孢他啶組,體外抗菌活性顯著優(yōu)于頭孢他啶組。

引用本文： 黃春暉. 頭孢吡肟聯(lián)合阿米卡星治療血液腫瘤粒缺期細(xì)菌性肺炎的療效觀察. 華西醫(yī)學(xué), 2009, 24(5): 1242-1244. doi: 復(fù)制

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9. 鄭衛(wèi).氨基糖甙類抗生素研究新進(jìn)展[J].國(guó)外醫(yī)學(xué)抗生素分冊(cè),2005,26(3):101.
10. 陳雪融,姚蓉,梁宗安,等.鹽酸頭孢吡肟治療下呼吸道感染和泌尿系感染的多中心隨機(jī)對(duì)照臨床研究[J].華西藥學(xué)雜志,2007,22(4):457458.
  1. 1. 張之南.血液病診斷及療效標(biāo)準(zhǔn)[M].第2版.北京:科學(xué)技術(shù)出版社,1998:164165.
  2. 2. 沈楊,沈睿,陳鈺,等.血液腫瘤合并感染病原菌流行病學(xué)及耐藥性研究[J].中華血液學(xué)雜志,2004,25(6):328332.
  3. 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. 4. 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)．社區(qū)獲得性肺炎診斷和治療指南[J].中華結(jié)核和呼吸雜志,2006,29(10):651655.
  5. 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. 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. 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. 8. 萬(wàn)建華,張靜萍,儲(chǔ)云卓,等.阿米卡星對(duì)產(chǎn)ESBLs大腸埃希菌的體外抗菌活性[J].第四軍醫(yī)大學(xué)學(xué)報(bào),2004,25(15):13651367.
  9. 9. 鄭衛(wèi).氨基糖甙類抗生素研究新進(jìn)展[J].國(guó)外醫(yī)學(xué)抗生素分冊(cè),2005,26(3):101.
  10. 10. 陳雪融,姚蓉,梁宗安,等.鹽酸頭孢吡肟治療下呼吸道感染和泌尿系感染的多中心隨機(jī)對(duì)照臨床研究[J].華西藥學(xué)雜志,2007,22(4):457458.