多巴酚丁胺注射液联合替考拉宁注射剂治疗革兰氏阳性球菌重症肺炎的临床研究
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摘要
目的观察多巴酚丁胺注射液联合替考拉宁注射剂治疗革兰氏阳性球菌重症肺炎的临床疗效和安全性。方法将64例革兰氏阳性球菌重症肺炎患儿随机分为试验组和对照组,每组32例。对照组予以2.5μg·kg~(-1)·min~(-1)多巴酚丁胺,每次3~4 h,qd,静脉滴注;试验组在对照组治疗的基础上,予以10mg·kg~(-1)替考拉宁,每次不少于30 min,qd,静脉滴注。2组患儿均治疗7 d。比较2组患儿的临床疗效和细菌清除率,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为90.63%(29例/32例)和71.88%(23例/32例),病原菌总清除率分别为90.63%(29例/32例)和75.00%(24例/32例),差异均有统计学意义(均P<0.05)。2组患儿发生的药物不良反应以心悸、腹泻和头痛为主。试验组和对照组的总药物不良反应率分别为12.50%和15.63%,差异无统计学意义(P>0.05)。结论多巴酚丁胺注射液联合替考拉宁注射剂治疗革兰氏阳性球菌重症肺炎的临床疗效确切,其能提高病原菌的清除率,且不增加药物不良反应发生率。
Objective To observe the clinical efficacy and safety of dobutamine injection combined with teicoplanin injection in the treatment of Gram-positive cocci severe pneumonia. Methods A total of 64 children with Gram-positive cocci severe pneumonia were randomly divided into control and treatment groups with 32 cases per group. Control group was given 2. 5 μg·kg~(-1)·min~(-1) dobutamine for 3-4 h,qd,intravenous drip. Treatment group was 10 mg ·kg~(-1) teicoplanin,no less than30 min per time,qd,intravenous drip,on the basis of control group.Two groups were treated for 7 d. The clinical efficacy,bacterial clearance and adverse drug reactions were compared between two groups.Results After treatment,the main indexes of treatment and control groups were compared: the total effective rates were 90. 63%( 29 cases/32 cases) and 71. 88%( 23 cases/32 cases),the total pathogenic bacteria clearance rates were 90. 63%( 29 cases/32 cases) and 75. 00%( 24 cases/32 cases),the differences were statistically significant( all P < 0. 05). The adverse drug reactions of two groups were heart palpitations,diarrhea and headache. The total incidences of adverse drug reaction rates in treatment and control groups were 12. 50% and 15. 63% without significant difference( P > 0. 05).Conclusion Dobutamine injection combined with teicoplanin injection has a definitive clinical efficacy in the treatment of Gram-positive cocci severe pneumonia,which can improve the clearance rate of pathogenic bacteria,without increasing the incidence of adverse drug reactions.
Objective To observe the clinical efficacy and safety of dobutamine injection combined with teicoplanin injection in the treatment of Gram-positive cocci severe pneumonia. Methods A total of 64 children with Gram-positive cocci severe pneumonia were randomly divided into control and treatment groups with 32 cases per group. Control group was given 2. 5 μg·kg~(-1)·min~(-1) dobutamine for 3-4 h,qd,intravenous drip. Treatment group was 10 mg ·kg~(-1) teicoplanin,no less than30 min per time,qd,intravenous drip,on the basis of control group.Two groups were treated for 7 d. The clinical efficacy,bacterial clearance and adverse drug reactions were compared between two groups.Results After treatment,the main indexes of treatment and control groups were compared: the total effective rates were 90. 63%( 29 cases/32 cases) and 71. 88%( 23 cases/32 cases),the total pathogenic bacteria clearance rates were 90. 63%( 29 cases/32 cases) and 75. 00%( 24 cases/32 cases),the differences were statistically significant( all P < 0. 05). The adverse drug reactions of two groups were heart palpitations,diarrhea and headache. The total incidences of adverse drug reaction rates in treatment and control groups were 12. 50% and 15. 63% without significant difference( P > 0. 05).Conclusion Dobutamine injection combined with teicoplanin injection has a definitive clinical efficacy in the treatment of Gram-positive cocci severe pneumonia,which can improve the clearance rate of pathogenic bacteria,without increasing the incidence of adverse drug reactions.
引文
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[2]YU K O,RANDOLPH A G,AGAN A A,et al.Staphylococcus aureusα-toxin response distinguishes respiratory virus-methicillinresistant S.aureus coinfection in children[J].J Infect Dis,2016,214(11):1638-1646.
[3]陈日金.小剂量多巴胺与多巴酚丁胺联合辅助治疗小儿重症肺炎的临床疗效及对血清细胞因子水平的影响[J].中国妇幼保健,2012,27(1):71-72.
[4]中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[J].中国急救医学,2016,36(2):97-107.
[5]FRANK M I,BODDU S H,MAURO V F,et al.Physical compatibility of valproate sodium injection with dobutamine and dopamine[J].Am J Health Syst Pharm,2017,74(5):280-281.
[6]朱丽芳,孙永法,左富凤.多巴胺、多巴酚丁胺、氨溴索联合佐治小儿重症肺部感染疗效及对免疫、炎性因子水平影响[J].中华医院感染学杂志,2016,26(22):5207-5209.