国产利奈唑胺治疗革兰氏阳性球菌感染重症肺炎患者疗效评价及其影响因素分析

Study on the Efficiency of Domestic Linazolamide in the Treatment Process of Severe Pneumonia Infected with Gram-positive Cocci and Its Influencing Factors

关键词:  利奈唑胺  革兰氏阳性球菌  感染  重症肺炎  治疗效果  影响因素

Key words:  domestic linazolamide  gram-positive cocci  infected  severe pneumonia  treatment effect  influencing factors

摘要:

目的 探讨国产利奈唑胺治疗革兰氏阳性球菌感染重症肺炎患者的疗效及其影响因素。方法 以安阳市人民医院2016年1月-2017年12月收治的80例革兰氏阳性球菌感染重症肺炎患者作为研究对象，并采用前瞻性研究。其中42例患者使用国产利奈唑胺进行治疗（观察组），38例患者使用去甲万古霉素进行治疗（对照组），观察并比较2组患者的治疗效果。同时根据治疗是否有效，将其分为有效组（n=49）与无效组（n=31），并通过logistic回归模型分析影响患者预后的危险因素。结果 治疗后，观察组患者MDA、IL-1β和TNF-α水平明显低于对照组（P<0.05），而该组患者SOD、LHP、TGF-β、血气分析指标、肺功能指标水平明显高于对照组（P<0.05）；观察组患者治疗总有效率明显高于对照组（73.81% vs 47.37%，P<0.05）；logistic回归分析结果表明APACHE Ⅱ评分、72 h内累积液体总出入量是否为正平衡、通气方式等均为影响患者预后的独立危险因素。结论 采用国产利奈唑胺治疗革兰氏阳性球菌感染重症肺炎患者，能有效改善其肺功能，降低机体炎性反应，治疗效果显著。另外，针对72 h内累积液体总出入量是否为正平衡、通气方式等独立危险因素，应及时采取预防措施，提高患者预后。

Abstract:

OBJECTIVE To study on efficiency of domestic linazolamide in the treatment process of severe pneumonia infected with gram-positive cocci and its influencing factors. METHODS The 80 patients with severe pneumonia infected with gram-positive cocci were treated in Anyang People's Hospital from January 2016 to December 2017. They were considered as study objects and were analyzed prospectively. They were divided into observation group treated with domestic linzolamide (n=42) and control group treated with norvancomycin(n=38). The treatment effects were observed and compared. At the same time, according to the recurrence or not for these patients, they were divided into efficiency group(n=49) and non-efficiency group(n=31). The risk of prognostic factors were analyzed by logistic regression model. RESULTS After treatment, the index including MDA, IL-1β and TNF-α were significantly lower in observation group compared with the control group(P<0.05), while the level of SOD, LHP, TGF-b, blood gas analysis index and lung function index in observation group was higher than that of control group(P<0.05). The effective rate in the observation group was significantly higher than the control group(73.81% vs 47.37%, P<0.05). The results of logistic regression analysis showed that APACHEⅡ, whether the total volume of cumulative fluid in 72 h was in a positive balance, and the ventilation pattern were independent risk factors for the prognosis of the patients. CONCLUSION Domestic linazolamide is used in the treatment process of severe pneumonia infected with gram-positive cocci, and it can effectively improve the pulmonary function of the patients and reduce the inflammatory reaction of the body. The therapeutic effect is remarkable. In addition, preventive measures shall be taken in time to improve the prognosis of patients with need for mechanica1ventilation and positive balance of fluid accumulationin 72 h.