摘要
目的探讨亚胺培南／西司他丁（泰能组）单用及头孢三代并阿米卡星（联合组）对粒细胞减少症合并感染病人的治疗效果，指导对此类病人的临床用药。②方法回顾性分析１３４例粒细胞减少症病人应用两组药物的有效率及细菌清除率。③结果泰能组有效５９例（８９％），联合组为５０例（７３％），二者比较差异有显著性（χ２＝３１．９２，Ｐ＜０．００５）；泰能组和联合组对革兰阳性细菌清除率分别为８７％和７２％，两者比较差异有显著性（χ２＝１１５．５４，Ｐ＜０．００５）；对革兰阴性细菌清除率分别为８４％和７５％，两者比较差异无显著性（χ２＝２．９２，Ｐ＞０．０５）；两组总细菌清除率分别为８６％和７３％，两者比较差异有显著性（χ２＝６３．８９．Ｐ＜０．００５）。联合用药无效者换用泰能有效率为７８％（１４／１８），泰能无效组改用联合用药者均无效。④结论泰能疗效优于头孢三代并阿米卡星，联合用药无效者应用泰能仍有较好疗效。
Objective To assess the effect of imipenem/cilastin(TIENAM) alone and combination therapy of a thirdgeneration cephalosporin plus amikacin(combination group) for the management of patients with neutropenia so as to instruct the empirical antibiotic therapy for the patients. Methods Of 134 evaluable episodes of neutropenia, 66 were treated with TIENAM alone and 68 with the combination therapy. All episodes were evaluated with response rates(RR) and bacteria elimination rate(BER). Results The response rate was 89%(59/66) in TIENAM group and 73% (50/68) in the combination therapy group. The difference of the two groups was significant(χ2=31.92,P< 0.005). Documented bacteria infection was 87/134 cases, including 48 episodes of Grampositive bacteria and 39 of Gramnegative bacteria. BER of Grampositive bactera in TIENAM group was 87%, 72% in the combination therapy group.The difference of the two groups was significant(χ2=115.54,P<0.005). BER of Gramregative bacteria in TIENAM group was 84%, in the combination therapy group, 75%, the difference was not significant(χ2=2.92,P>0.05). The total elimination rate of bacteria in TIENAM and combination group were 86% and 73% respectively. The difference was significant(χ2=63.89,P<0.005) The RR of patients failed to combination therapy was 78% to TIENAM therapy, while those failed to TIENAM therapy was not responsive to combination therapy either. Conclusion The efficacy of TIENAM as single agent for the management of neutropenia is superior to the combination of a thirdgeneration caphalosporin plus amikacin. Patients failed to combination therapy should be treated with TIENAM.
出处
《青岛医学院学报》
1998年第4期262-264,共3页
Acta Academiae Medicinae Qingdao Universitatis
