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目的:观察头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效和不良反应。方法:120例入选患者随机分为治疗组和对照组,每组60例,分别接受头孢吡肟联合阿米卡星及头孢他啶联合阿米卡星治疗。其中,头孢吡肟或头孢他啶均为2g加入生理盐水100mL,每日2次,静脉点滴;阿米卡星0.4g,加入生理盐水500mL中,每日1次,静脉点滴,治疗持续一般1～2周。采用卫生部1993年抗菌药物临床研究指导原则进行判断疗效。结果:治疗组与对照组有效率分别为80%、76.7%,细菌清除率分别为91.9%、90.2%。两组比较差异无统计学意义(P>0.05)。两组患者共分离出病原菌123株,药敏试验显示对头孢吡肟的敏感率为90.2%,显著高于头孢他啶69.7%,差异有统计学意义(P<0.01)。不良反应主要有恶心及皮疹等,均可耐受。发生率分别为5%和11%,两组比较差异无统计学意义(P>0.05)。结论:头孢吡肟联合阿米卡星治疗血液肿瘤粒缺期细菌性肺炎的疗效略优于头孢他啶组,体外抗菌活性显著优于头孢他啶组。
Objective: To observe the efficacy and adverse reactions of cefepime in combination with amikacin in the treatment of bacterial pneumonia in patients with hematogenous neoplasms. Methods: 120 patients were randomly divided into treatment group and control group, 60 cases in each group, receiving cefepime in combination with amikacin and ceftazidime in combination with amikacin. Among them, cefepime or ceftazidime were added 2g normal saline 100mL, 2 times a day, intravenous drip; Amikacin 0.4g, added 500mL of normal saline once daily, intravenous drip, the treatment lasts 1 ~ 2 week. The Ministry of Health 1993 antibacterial clinical research guidelines to determine the efficacy. Results: The effective rates of the treatment group and the control group were 80% and 76.7% respectively, and the bacterial clearance rate was 91.9% and 90.2% respectively. There was no significant difference between the two groups (P> 0.05). A total of 123 pathogenic bacteria were isolated from the two groups. The susceptibility test showed that the sensitivity to cefepime was 90.2%, which was significantly higher than that of ceftazidime (69.7%), the difference was statistically significant (P <0.01). Adverse reactions are mainly nausea and rash, etc., can be tolerated. The incidence rates were 5% and 11% respectively, with no significant difference between the two groups (P> 0.05). Conclusion: Cefepime combined with amikacin is superior to ceftazidime in the treatment of bacterial pneumonia with bacterial neutropenia, and the antibacterial activity in vitro is significantly better than that of ceftazidime.