亚胺培南西司他丁钠和美罗培南治疗急性白血病粒细胞减少期合并重症肺部感染的效果比较

摘要

目的:比较亚胺培南西司他丁钠和美罗培南治疗急性白血病粒细胞减少期合并重症肺部感染的临床疗效及安全性.方法:选取2015年7月-2016年7月儋州市人民医院收治的急性白血病粒细胞减少期合并重症肺部感染患者64例作为研究对象,按照入院顺序号,单数为试验组,双数为对照组,各32例.对照组患者给予注射用美罗培南1 g+0.9％氯化钠注射液100 mL,ivgtt(约30 min),q8 h;试验组患者给予注射用亚胺培南西司他丁钠1 g+0.9％氯化钠注射液100 mL,ivgtt(约30 min),q12 h.两组患者均治疗14 d.观察两组患者临床疗效、治疗前后的血气参数{血氧分压[p(O2)]、血二氧化碳分压[p(CO2)]、血氧饱和度(SaO2)}水平和病原菌清除情况,并记录不良反应发生情况.结果:试验组患者的临床总有效率(78.13％)明显高于对照组(71.88％),差异有统计学意义(P0.05).治疗后,两组患者p(O2)和SaO2水平均明显升高,p(CO2)水平明显降低,与治疗前比较差异有统计学意义(P0.05).试验组患者的总不良反应发生率(9.38％)明显低于对照组(15.63％),差异无统计学意义(P>0.05).结论:亚胺培南西司他丁钠和美罗培南治疗急性白血病粒细胞减少期合并重症肺部感染的临床疗效、对血气参数的改善作用、病原菌清除效果均较好,亚安全性均较高.%OBJECTIVE:To compare the clinical efficacy and safety of imipenem and cislastatin sodium and meropenem in the treatment of acute leukemia granulocytopenic phase combined with severe lung infection. METHODS:A total of 64 patients with acute leukemia granulocytopenic phase combined with severe lung infection were selected from our hospital during Jul. 2015-Jul. 2016 as study objects. They were divided into trial group(odd number)and control group(even number)according to admis-sion order,with 32 cases in each group. Control group was given Meropenem for injection 1 g+0.9％ Sodium chloride injection 100 mL,ivgtt(about 30 min),q8 h. Trial group was given Imipenem and cislastatin sodium for injection 1 g+0.9％ Sodium chlo-ride injection 100 mL,ivgtt(about 30 min),q12 h. Both groups were treated for 14 d. Clinical efficacies as well as blood gas pa-rameters [p(O2),p(CO2),SaO2] and pathogenic clearance were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:The total response rate of trial group(78.13％)was significantly higher than that of control group(71.88％),with sta-tistical significance (P0.05). After treatment,the levels of p(O2) and SaO2 in 2 groups were in-creased significantly,while the level of p(CO2) was decreased significantly;there was statistical significance compared to be-fore treatment(P>0.05). There were 27 cases of pathogenic clearance in trial group(clearance rate of 84.38％),which was sig-nificantly more than control group (26 cases,clearance rate of 81.25％),without statistical significance (P>0.05). The inci-dence of ADR in trial group(9.38％)was significantly lower than control group(15.63％),without statistical significance(P>0.05). CONCLUSIONS:Imipenem and cislastatin sodium and meropenem show good clinical efficacy for acute leukemia granu-locytopenic phase combined with severe lung infection,blood gas parameters improvement and pathogenic clearance effect,both of them have good safety.