利奈唑胺治疗耐甲氧西林金黄色葡萄球菌性重症肺炎及其对血清炎性因子的影响

摘要

目的 探讨利奈唑胺治疗耐甲氧西林金黄色葡萄球菌性重症肺炎(methicillin resistant staphylococcus aureus of severe pneumonia,MRSA-SP)及其对血清炎性因子的影响.方法 选择2014年7月至2017年6月入住我院ICU的MRSA-SP患者98例,按照随机数字表法分为利奈唑胺组与万古霉素组各49例.利奈唑胺组行常规治疗+利奈唑胺治疗,万古霉素组行常规治疗+万古霉素治疗.观察两组治疗前后血乳酸(Lac)、一氧化氮(NO)、内皮素(ET)、降钙素原(PCT)等实验室指标,白介素-6(IL-6)、白介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)等炎性因子指标及不良反应.结果 治疗后,利奈唑胺组Lac、NO、ET、PCT及血清IL-6、IL-1β、TNF-α、CRP水平均低于万古霉素组;细菌清除率、总有效率高于万古霉素组(P<0.05).两组不良反应发生率差异无统计学意义(P>0.05).结论 利奈唑胺治疗MRSA-SP可有效清除细菌,降低血清炎性因子水平,疗效显著.%Objective To investigate the effect of linezolid in the treatment of severe pneumonia caused by methicillin resist-ant Staphylococcus aureus(MRSA~SP) and its influence on serum inflammatory factors.Methods A total of 98 patients of MRSA~SP patients admitted to ICU of our hospitals from July 2014 to June 2017 were selected.The patients were divided into linezolid group (n = 49) and vancomycin group(n = 49) using the random number table method.The patients in the linezolid group were performed conventional therapy plus linezolid therapy while the patients in the vancomycin group were performed conventional therapy plus vanco-mycin therapy.The laboratory indexes such as blood lactic acid (Lac),nitric oxide (NO),endothelin (ET) and procalcitonin (PCT) as well as inflammatory factor indexes such as interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),C reac-tive protein(CRP),and adverse reactions of the two groups before and after treatment were observed.Results After treatment,the lev-els of Lac,NO,ET and PCT and serum levels of IL-6,IL-1β,TNF-α and CRP in the linezolid group were lower than those in the vanco-mycin group (P <0.05).The bacteria clearance rate and total effective rate in the linezolid group were higher than those in the vanco-mycin group (P < 0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05).Conclusion Linezolid can effectively remove bacteria and lower the serum levels of inflammatory factors in the treatment of MRSA~SP and the curative effect is significant.