亚胺培南西司他丁治疗老年肺部感染的疗效观察与药动学研究
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摘要
目的:探讨亚胺培南西司他丁治疗老年肺部感染的疗效与药动学参数变化情况。方法:选取2014年4月—2016年5月濮阳市人民医院收治的老年肺部感染患者84例作为研究对象。根据入院先后顺序分为观察组和对照组,每组各42例。对照组患者给予头孢哌酮钠舒巴坦钠,观察组患者给予亚胺培南西司他丁。观察2组患者的临床疗效、细菌清除率、不良反应发生率,并分析亚胺培南西司他丁药动学参数变化情况。结果:观察组患者的总有效率为95.24%(40/42),明显高于对照组的76.19%(32/42),差异有统计学意义(P<0.05);观察组患者的细菌清除率明显高于对照组,差异有统计学意义(P<0.05);2组患者不良反应发生率的差异无统计学意义(P>0.05)。亚胺培南西司他丁的峰值浓度为(27.35±0.68)mg/L,半衰期约为1.0 h。结论:亚胺培南西司他丁治疗老年肺部感染的疗效显著,安全性较高,且药物在肺部组织中浓度较高,半衰期较短。
OBJECTIVE: To probe into the efficacy of imipenem cilastatin in treatment of elderly pulmonary infection and the changes of pharmacokinetics parameters. METHODS: 84 elderly patients with pulmonary infection admitted into Puyang People's Hospital from Apr. 2014 to May 2016 were selected to be divided divided into observation group and control group via the visiting sequence,with 42 cases in each. The control group were treated with cefoperazone sodium and sulbactam sodium,while the observation group received imipenem cilastatin. The clinical efficacy,bacterial clearance rate,incidence of adverse drug reactions of two groups were observed. And changes of imipenem and cilastatin pharmacokinetics were analyzed. RESULTS: The total effective rate of observation group was 95. 24%( 40 /42),significantly higher than that of control group [76. 19%( 32 /42) ],with statistically significant difference( P < 0. 05).The bacterial clearance rate of observation group was significantly higher than that of control group,with statistically significant difference( P < 0. 05). There was no statistical significance between two groups in the incidence of adverse drug reactions( P > 0. 05). The peak concentration of imipenem cilastatin was( 27. 35 ± 0. 68) mg / L,the half-life was about 1. 0 h. CONCLUSIONS: The efficacy of imipenem cilastatin in treatment of elderly pulmonary infection is remarkable with high safety,and the drug concentration in lung tissue is high with short half-life.
OBJECTIVE: To probe into the efficacy of imipenem cilastatin in treatment of elderly pulmonary infection and the changes of pharmacokinetics parameters. METHODS: 84 elderly patients with pulmonary infection admitted into Puyang People's Hospital from Apr. 2014 to May 2016 were selected to be divided divided into observation group and control group via the visiting sequence,with 42 cases in each. The control group were treated with cefoperazone sodium and sulbactam sodium,while the observation group received imipenem cilastatin. The clinical efficacy,bacterial clearance rate,incidence of adverse drug reactions of two groups were observed. And changes of imipenem and cilastatin pharmacokinetics were analyzed. RESULTS: The total effective rate of observation group was 95. 24%( 40 /42),significantly higher than that of control group [76. 19%( 32 /42) ],with statistically significant difference( P < 0. 05).The bacterial clearance rate of observation group was significantly higher than that of control group,with statistically significant difference( P < 0. 05). There was no statistical significance between two groups in the incidence of adverse drug reactions( P > 0. 05). The peak concentration of imipenem cilastatin was( 27. 35 ± 0. 68) mg / L,the half-life was about 1. 0 h. CONCLUSIONS: The efficacy of imipenem cilastatin in treatment of elderly pulmonary infection is remarkable with high safety,and the drug concentration in lung tissue is high with short half-life.
引文
[1]陈刚,徐永芳,徐长青,等.亚胺培南/西司他丁治疗重症医院获得性肺炎临床观察[J].中华医院感染学杂志,2016,26(7):1498-1499,1502.
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[9]李晓康.亚胺培南西司他丁与莫西沙星治疗老年重症社区获得性肺炎的疗效比较[J].临床肺科杂志,2013,18(10):1886-1888.
[10]王秀琴,柯森方,张春柳.亚胺培南/西司他丁钠与美罗培南治疗重症感染的成本-效果分析[J].中国综合临床,2013,29(4):387-389.
[11]麦叶,朱永,吴远怡.亚胺培南西司他丁钠持续泵入治疗重症医院获得性肺炎的疗效观察[J].山西医药杂志,2016,45(7):808-810.
[12]孙沛.亚胺培南-西司他丁钠降阶梯疗法治疗重症肺炎43例临床疗效分析[J].贵州医药,2015,39(9):791-792.
[13]王旭东,饶芝国,刘丽娜,等.亚胺培南西司他丁钠联合山莨菪碱治疗难治性重症肺炎的疗效观察[J].中国医刊,2013,48(12):51-53.
[14]周甘平,林春燕,黄华田.1例高龄患者肺部多重耐药菌感染的药学监护[J].医药导报,2015,34(8):1106-1108.
[15]栾微,叶寰,刘涛,等.亚胺培南-西司他丁联合去甲万古霉素治疗获得性下呼吸道感染的效果[J].现代生物医学进展,2015,15(22):4295-4297.
[2]李梅,李琼阁,高靓,等.国产与进口亚胺培南西司他丁钠治疗重症下呼吸道感染的成本-效果比较[J].中国药房,2016,27(14):1881-1883.
[3]韩秀峰,刘广辉.亚胺培南西司他丁治疗老年肺部感染的临床观察[J].中国处方药,2016,14(7):66-67.
[4]刘茂昌,葛苗苗,陈渝军,等.美罗培南与亚胺培南/西司他汀治疗重症感染疗效与安全性的Meta分析[J].中国抗生素杂志,2014,39(10):785-790.
[5]山凤莲,邵泽伟,山峰.亚胺培南/西司他丁联合去甲万古霉素对下呼吸道感染患者治疗效果研究[J].中华医院感染学杂志,2015,25(5):1047-1049.
[6]王霞,唐卫东,史东明.亚胺培南/西司他丁输注时间对重症肺炎的疗效影响[J].全科医学临床与教育,2015,13(2):153-155.
[7]江建生,石杰,张新慧,等.美罗培南与亚胺培南/西司他丁治疗呼吸系统感染疗效与安全性之Meta分析[J].中国医刊,2013,48(8):30-33.
[8]赵丽丽,张瑶,张虹.亚胺培南/西司他丁对重症肺炎的降阶梯治疗疗效分析[J].中国药物经济学,2014,9(10):219-220.
[9]李晓康.亚胺培南西司他丁与莫西沙星治疗老年重症社区获得性肺炎的疗效比较[J].临床肺科杂志,2013,18(10):1886-1888.
[10]王秀琴,柯森方,张春柳.亚胺培南/西司他丁钠与美罗培南治疗重症感染的成本-效果分析[J].中国综合临床,2013,29(4):387-389.
[11]麦叶,朱永,吴远怡.亚胺培南西司他丁钠持续泵入治疗重症医院获得性肺炎的疗效观察[J].山西医药杂志,2016,45(7):808-810.
[12]孙沛.亚胺培南-西司他丁钠降阶梯疗法治疗重症肺炎43例临床疗效分析[J].贵州医药,2015,39(9):791-792.
[13]王旭东,饶芝国,刘丽娜,等.亚胺培南西司他丁钠联合山莨菪碱治疗难治性重症肺炎的疗效观察[J].中国医刊,2013,48(12):51-53.
[14]周甘平,林春燕,黄华田.1例高龄患者肺部多重耐药菌感染的药学监护[J].医药导报,2015,34(8):1106-1108.
[15]栾微,叶寰,刘涛,等.亚胺培南-西司他丁联合去甲万古霉素治疗获得性下呼吸道感染的效果[J].现代生物医学进展,2015,15(22):4295-4297.