2022 年第 1 期 第 17 卷

利奈唑胺联合美罗培南治疗老年重症肺部感染患者的效果和安全性

Effect and safety of linezolid combined with meropenem on the treatment of severe pulmonary infection in elderly patients

作者：张政1徐一鹏2朱满刚1

英文作者：Zhang Zheng1 Xu Yipeng2 Zhu Mangang1

单位：1杭州市中医院急诊科，杭州310007；2中国科学院大学附属肿瘤医院泌尿肿瘤外科，杭州310022

英文单位：1Department of Emergency Hangzhou Hospital of Traditional Chinese Medicine Hangzhou 310007 China; 2Department of Urology Oncology Surgery Cancer Hospital of The University of Chinese Academy of Sciences Hangzhou 310022 China

关键词：重症肺部感染；利奈唑胺；美罗培南

英文关键词：Severepulmonaryinfection;Linezolid;Meropenem

• 摘要：

• 目的 探索利奈唑胺联合美罗培南治疗老年重症肺部感染患者的效果和安全性。方法 选取2017年6月至2019年10月杭州市中医院呼吸与危重症医学科收治的老年重症肺部感染患者78例。按照随机数字表法分为对照组（37例）与观察组（41例）。对照组在常规治疗基础上给予美罗培南静脉滴注治疗14 d；观察组在对照组基础上加用利奈唑胺静脉滴注治疗14 d。比较2组治疗结束后28 d病死率，观察2组治疗后症状体征消失时间、动脉血气指标、白细胞计数和痰菌转阴时间及不良反应发生率的差异。结果 治疗结束后28 d观察组病死率低于对照组［22.0%（9/41）比43.2%（16/37）］，差异有统计学意义（P<0.05）。观察组咳嗽、咳痰、肺部湿啰音、发热消失时间均短于对照组，差异均有统计学意义（均P<0.05）。治疗后2组动脉血氧分压与动脉血氧饱和度均高于治疗前、且观察组高于对照组，动脉血二氧化碳分压均低于治疗前、且观察组低于对照组，差异均有统计学意义（均P＜0.05）。治疗后观察组白细胞计数低于、痰菌转阴时间短于对照组，治疗期间不良反应发生率低于对照组，差异均有统计学意义（均P<0.05）。结论  利奈唑胺联合美罗培南对老年重症肺部感染患者的疗效确切且安全性较高。

• Objective   To investigate effect and safety of linezolid combined with meropenem on the treatment of severe pulmonary infection in elderly patients. Methods  Totally 78 elderly patients with severe pulmonary infection admitted to Department of Respiratory and Critical Care Medicine, Hangzhou Hospital of Traditional Chinese Medicine from June 2017 to October 2019 were selected. They were divided into control group (37 cases) and observation group (41 cases) according to the random number table method. The control group was given meropenem intravenous drip on the basis of conventional treatment for 14 d; the observation group was given linezolid intravenous drip for 14 d on the basis of the control group. The fatality rate of 28 d after the treatment was compared between the two groups. The time of disappearance of symptoms and signs, arterial blood gas indexes, white blood cell count, sputum bacteria turning negative time and the incidence of adverse reactions of the two groups were observed. Results  After 28 d of treatment, the fatality rate of the observation group was lower than that of the control group［22.0%(9/41) vs 43.2%(16/37)］(P<0.05). The disappearance time of cough, expectoration, lung moist rales and fever of the observation group were shorter than those of the control group (all P<0.05). After treatment, arterial oxygen partial pressure and arterial oxygen saturation of both groups were higher than those before treatment, and those of the observation group were higher than those of the control group; arterial carbon dioxide partial pressure of both groups was lower than that before treatment, and that of the observation group was lower than that of the control group (all P<0.05). After treatment, the white blood cell count of the observation group was lower than that of the control group, the sputum bacteria turnin negative time of the the observation group was shorter than that of the control group, and the incidence of adverse reactions during treatment of the observation group was lower than that of the control group (all P<0.05). Conclusion  Linezolid combined with meropenem is effective and safe on the treatment of severe pulmonary infection in elderly patients.