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目的比较利奈唑胺与万古霉素对ICU患者耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染的疗效及安全性。方法对2008年5月至2010年11月温州市中医院收治的72例肺部MRSA感染的患者,分别给予利奈唑胺(0.6 g/次,每日2次)和万古霉素(1.0 g/次,每日2次)治疗,观察并比较两种方法的临床疗效、细菌学疗效及不良反应。结果万古霉素与利奈唑胺治疗MRSA的治愈率分别为25.7%和18.9%,临床总有效率分别为65.7%和51.4%,细菌清除率分别为71.4%和48.6%,不良反应总发生率为8.5%和5.4%,两组间MRSA治愈率、总有效率和不良反应总发生率比较差异无统计学意义(P>0.05),细菌清除率比较差异有统计学意义(P<0.05)。结论对于ICU患者肺部MRSA感染,利奈唑胺与万古霉素敏感率均很高,总体疗效相似,且安全性及耐受性较好,利奈唑胺痰菌清除率略高于后者。
Objective To compare the efficacy and safety of linezolid and vancomycin against ICU patients with methicillin-resistant Staphylococcus aureus (MRSA) pulmonary infection. Methods 72 patients with MRSA infection from May 2008 to November 2010 in Wenzhou City Hospital were treated with linezolid (0.6 g / time, twice daily) and vancomycin (1.0 g / Times a day, twice a day) treatment, observe and compare the clinical efficacy of the two methods, bacteriological efficacy and adverse reactions. Results The cure rates of vancomycin and linezolid were 25.7% and 18.9% respectively, the total effective rates were 65.7% and 51.4%, the bacterial clearance rates were 71.4% and 48.6% respectively. The total incidence of adverse reactions was 8.5% and 5.4%, respectively. There was no significant difference in the cure rate, total effective rate and total adverse reaction rate between the two groups (P> 0.05). There was significant difference in bacterial clearance between the two groups (P <0.05). Conclusions The sensitivity of linezolid to vancomycin in ICU patients with MRSA was high, the overall curative effect was similar, and the safety and tolerability were better. The clearance rate of linezolid was slightly higher than that of linezolid.