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目的:总结分析利奈唑胺治疗革兰阳性球菌感染的老年心功能不全患者的临床疗效及安全性。方法:回顾分析4家医院2009年1月-2011年1月收治的使用利奈唑胺治疗的革兰阳性球菌感染的35例心功能不全老年患者的临床资料。结果:全部患者均检出革兰阳性菌株,25例感染部位为肺,10例为血液,利奈唑胺治疗后总有效率为82.9%,有效时间为3～10d,有24例直接使用利奈唑胺治疗,用药后清除21例(87.5%),11例为万古霉素无效或不能耐受后换用利奈唑胺治疗,用药后清除8例(72.7%),共6例出现不良反应,3例皮疹,2例血小板减少,1例腹泻,全部患者都能够耐受。结论:利奈唑胺治疗革兰阳性球菌感染的老年心功能不全患者疗效确切、安全,可一线应用于抗革兰阳性球菌感染治疗或万古霉素治疗无效时换用利奈唑胺。
Objective: To summarize the clinical efficacy and safety of linezolid in the treatment of Gram-positive cocci infection in elderly patients with heart failure. Methods: The clinical data of 35 elderly patients with Gram-positive cocci infection treated with linezolid in 4 hospitals from January 2009 to January 2011 were retrospectively analyzed. RESULTS: Gram-positive strains were detected in all patients. Twenty-five infected sites were lungs, 10 were blood, the total effective rate was 82.9% after linezolid treatment, and the effective time was 3 to 10 days. Twenty-four patients were directly treated with linezolid After treatment, 21 cases (87.5%) were cleared, 11 cases were treated with linezolid after ineffective or intolerable vancomycin, and 8 cases (72.7%) were cleared after treatment. A total of 6 cases showed adverse reactions. 3 Case rash, 2 cases of thrombocytopenia, 1 case of diarrhea, all patients are able to tolerate. Conclusion: Linezolid is effective and safe in the treatment of Gram-positive cocci infection in elderly patients with heart failure. It can be used in the first-line treatment of Gram-positive cocci infection or linezolid in case of ineffective vancomycin treatment.