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    喻轶群, 杨其莲, 沈春英, 王晓娟, 韩冰. 高剂量替加环素对碳青霉烯治疗无效的下呼吸道感染疗效分析[J]. 蚌埠医科大学学报, 2020, 45(9): 1190-1193. DOI: 10.13898/j.cnki.issn.1000-2200.2020.09.013
    引用本文: 喻轶群, 杨其莲, 沈春英, 王晓娟, 韩冰. 高剂量替加环素对碳青霉烯治疗无效的下呼吸道感染疗效分析[J]. 蚌埠医科大学学报, 2020, 45(9): 1190-1193. DOI: 10.13898/j.cnki.issn.1000-2200.2020.09.013
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    YU Yi-qun, YANG Qi-lian, SHEN Chun-ying, WANG Xiao-juan, HAN bing. Analysis of the efficacy of high dose tigecycline in the treatment of lower respiratory tract infection with ineffective carbapenem treatment[J]. Journal of Bengbu Medical University, 2020, 45(9): 1190-1193. DOI: 10.13898/j.cnki.issn.1000-2200.2020.09.013
    Citation: YU Yi-qun, YANG Qi-lian, SHEN Chun-ying, WANG Xiao-juan, HAN bing. Analysis of the efficacy of high dose tigecycline in the treatment of lower respiratory tract infection with ineffective carbapenem treatment[J]. Journal of Bengbu Medical University, 2020, 45(9): 1190-1193. DOI: 10.13898/j.cnki.issn.1000-2200.2020.09.013
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    高剂量替加环素对碳青霉烯治疗无效的下呼吸道感染疗效分析

    Analysis of the efficacy of high dose tigecycline in the treatment of lower respiratory tract infection with ineffective carbapenem treatment

      摘要
    • 摘要:
      目的探讨高剂量替加环素对碳青霉烯类药物治疗无效的下呼吸道感染疗效。
      方法回顾性分析经碳青霉烯类药物治疗无效的下呼吸道感染病人85例，根据替加环素用药前是否有病原学证据，分为经验治疗组（26例）和目标治疗组（59例），其中目标治疗组下分CRAB亚组（36例）和CRKP亚组（23例），比较经验治疗组和目标治疗组病人的一般情况、临床有效率及炎症指标变化，同时分析与临床疗效相关的危险因素。
      结果CRAB组和CRKP组的高剂量替加环素临床有效率分别为63.89%和73.91%，均高于经验治疗组的临床有效率30.77%（P < 0.05和P < 0.01）；CRAB组和CRKP组的高剂量替加环素临床有效率之间差异无统计学意义（P>0.05）。在给予以高剂量替加环素为基础的抗感染治疗方案后，CRAB组和CRKP组的WBC、CRP、PCT均明显下降（P < 0.05），而经验治疗组仅CRP下降（P < 0.05），WBC及PCT在治疗前后差异无统计学意义（P>0.05）。Logistic回归分析发现是否重症对临床疗效的影响有统计学意义（P < 0.05）。
      结论对碳青霉烯类药物治疗无效的下呼吸道感染病人，给予以高剂量替加环素为基础的联合治疗总体具有较好的抗感染疗效，其中目标治疗较经验治疗疗效更佳。

       

      Abstract:
      ObjectiveTo investigate the effects of high dose tiagocycline in the treatment of lower respiratory tract infection with ineffective carbapenem treatment.
      MethodsThe clinical data of 85 lower respiratory tract infection patients with ineffective carbapenem treatment were analyzed retrospectively.According to the etiology of disease before administration, the patients were divided into the empirical treatment group(26 cases) and target treatment group(59 cases), and the target treatment group was subdivided into the CRAB group(36 cases) and CRKP group(23 cases).The clinical characteristics, clinical efficiency and inflammatory markers between the empirical treatment group and target treatment group were compared, and the risk factors of clinical efficacy was analyzed.
      ResultsThe clinical effective rate of high-dose tigecycline in CRAB group and CRKP group were 63.89% and 73.91%, respectively, which was significantly higher than that in empirical treatment group(30.77%)(P < 0.05 and P < 0.01).There was no statistical significance in clinical efficacy of high-dose tigecycline between CRAB group and CRKP group(P>0.05).After treatment with high-dose tigecyclne, the WBC, CRP and PCT in CRAB group and CRKP group decreased significantly(P < 0.05), while only CRP decreased significantly in empirical treatment group(P < 0.05), the differences of WBC and PCT were not statistically significant between before and after treatment(P>0.05).The results of logistic regression analysis showed that the severe disease had a significant effect on clinical efficiency(P < 0.05).
      ConclusionsFor lower respiratory tract infection patients with ineffective carbapenem treatment, the combination therapy based on high-dose tigecycline can achieve good anti-infective effect on the patients, and the target treatment is more effective than empirical treatment.

       

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