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目的观察莫西沙星对早发且无多重耐药危险因素的医院获得性肺炎临床疗效及预后影响。方法选取早发且无多重耐药危险因素的医院获得性肺炎患者60例,随机分为治疗组和对照组各30例。治疗组给予盐酸莫西沙星0.4g,加入0.9%氯化钠注射液250mL静脉滴注,qd;对照组给予头孢曲松钠2.0g,加入0.9%氯化钠注射液250mL静脉滴注,qd,两组均治疗7d,期间不联用其他抗菌药物,观察临床肺部感染评分(CPIS)、C反应蛋白(CRP)、细菌清除率、临床疗效,预后及安全性。结果治疗组有效率83.3%,对照组为66.7%。治疗组CPIS由治疗前(6.9±1.1)分降为(3.0±1.9)分,CRP由治疗前(43.0±5.1)降为(17.6±3.9)mg.L-1;对照组CPIS由(7.1±1.4)分降为(4.6±1.7)分,CRP由(41.5±6.3)降为(30.8±4.4)mg.L-1。治疗组细菌清除率为81.0%,对照组为63.2%。治疗组晚发医院获得性肺炎发生率为6.7%,病死率3.3%,对照组分别为16.7%和10.0%。结论莫西沙星治疗早发且无多重耐药危险因素的医院获得性肺炎能及早改善临床症状、缩短疗程和改善预后,疗效确切,安全性好。
Objective To observe the clinical effect and prognosis of moxifloxacin on hospital acquired pneumonia with risk factors of multiple premature and no multiple drug resistance. Methods Sixty patients with nosocomial pneumonia were randomly divided into treatment group and control group, with 30 cases in each group. The treatment group were given moxifloxacin hydrochloride 0.4g, adding 0.9% sodium chloride injection 250mL intravenous infusion, qd; control group was given ceftriaxone sodium 2.0g, adding 0.9% sodium chloride injection 250mL intravenous infusion, qd, Both groups were treated for 7 days without any other antimicrobial agents. The clinical pulmonary infection score (CPIS), C-reactive protein (CRP), bacterial clearance rate, clinical efficacy, prognosis and safety were observed. Results The effective rate was 83.3% in the treatment group and 66.7% in the control group. The CPIS decreased from (6.9 ± 1.1) to (3.0 ± 1.9) before treatment and from (43.0 ± 5.1) to (17.6 ± 3.9) mg.L-1 before treatment in the treatment group and from 7.1 ± 1.4) to (4.6 ± 1.7) points, CRP decreased from (41.5 ± 6.3) to (30.8 ± 4.4) mg.L-1. The bacterial clearance rate was 81.0% in the treatment group and 63.2% in the control group. The incidence of hospital acquired pneumonia was 6.7% and the case fatality rate was 3.3% in the treatment group and 16.7% and 10.0% in the control group respectively. Conclusion Moxifloxacin treatment of early-onset and no multiple risk factors of hospital-acquired pneumonia can improve clinical symptoms as soon as possible, shorten the course of treatment and improve the prognosis, curative effect is exact and good safety.