万古霉素治疗小儿败血症的疗效及对肝肾功能的影响

摘要

Objective To explore the effects of vancomycin in treating children with sepsis and its effect on liver and renal function.Methods Seventy-six children with sepsis in our hospital were randomized into study group (n =38) and control group (n =38).The control group was treated with cefuroxim while the study group was treated with vancomycin.The clinical curative effect and bacteriological curative effect in the two groups were observed.The levels of laboratory indexes [procalcitonin (PCT),C reactive protein (CRP)] and immune function indexes [immunoglobulin G (IgG),immunoglobulin M (IgM)] were detected and compared between the two groups before and after treatment.The incidence of adverse events such as liver and renal function damage was also compared.Results The clinical total effective rate of study group (87％) was higher than that of the control group (66％),the difference was significant (P＜0.05),and the bacterial clearance rate (89％) was slightly higher than that of the control group (79％) (P＜0.05).There were no significant differences in laboratory indexes and immune function indexes between the two groups before treatment (P＞0.05).After treatment,levels of PCT,CRP,IgG and IgM were significantly improved but levels of PCT and CRP in the study group were significantly lower than those of the control group (P＜0.01).IgG level was significantly higher than that of the control group while IgM level was significantly lower,the difference was significant (P＜0.01).There was no significant difference in the incidence of adverse events such as liver and renal function damage between the two groups (P＞ 0.05).Conclusion The clinical effect and bacteriological effect of vancomycin in treating children with sepsis are significant.It is useful to improve clinical laboratory indexes and immune function,with less damage to the liver and renal function.%目的 万古霉素治疗小儿败血症的疗效及对肝肾功能的影响.方法 将我院76例小儿败血症的患儿随机数字表法分为研究组38例和对照组38例.对照组给予头孢呋辛治疗,研究组给予万古霉素治疗.观察2组临床疗效和细菌学疗效,治疗前后检测和比较2组实验室指标[降钙素原(PCT)、C反应蛋白(CRP)]和免疫功能指标[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]水平,并比较肝肾功能损伤等不良事件发生情况.结果 研究组临床治疗总有效率为87％高于对照组66％,差异有统计学意义(P＜0.05),细菌学清除率89％略高于对照组79％,但2组比较差异无统计学意义(P＜0.05).2组治疗前实验室指标及免疫功能比较差异无统计学意义(P＞0.05),治疗后PCT、CRP及IgG、IgM水平均明显改善,但治疗后研究组PCT、CRP水平低于对照组(P＜0.01),IgG水平高于对照组,IgM低于对照组,差异有统计学意义(P＜0.01).2组肝肾功能损伤等不良事件发生率比较差异无统计学意义(P＞0.05).结论 万古霉素治疗小儿败血症的临床疗效及细菌学疗效显著,有利于改善临床实验室指标、免疫功能指标,且对肝肾功能的损伤较小.