解脲脲原体感染治疗效果影响因素调查研究

目的调查分析导致患者解脲脲原体(Uu)感染未能根治和治疗无效的相关因素,以提高临床Uu感染的治愈率。方法对Uu感染治疗无效或有残余支原体量的患者,分析其性别、给药途径、疗程、3类常用抗菌药物(大环内酯类、四环素类、喹诺酮类)选择、体外药物敏感试验等相关因素,并比较单一和联合用药治疗方案与Uu残余量的关系。结果克拉霉素、多西环素、米诺环素体外药敏试验敏感率依次为92.35%、87.76%、86.74%;而氧氟沙星、左氧氟沙星、罗红霉素敏感率仅为12.25%、35.71%、37.76%。性别、给药途径、疗程均影响Uu感染疗效(P<0.01):Uu未能根除患者中,女性患者占83.87%;静脉用药者占62.90%;疗程≤7d者占74.19%。克拉霉素治疗Uu感染所致Uu残留存在男女性别差异(P<0.01);联合用药组Uu转阴率为98.75%,高于单一药物治疗组(P<0.01)。结论选择敏感性药物,除考虑性别差异外,足疗程及联合用药有助于提高对患者泌尿生殖系残余Uu的清除。

Related factors of therapeutic efficacy on Ureaplasma urealyticum infections

Objective To investigate the related factors for the therapeutic failure of radical cure or inefficiency on Ureaplasma urealyticum(Uu) infection,so as to elevate the curing rate of infection.Methods Related factors were analysed,which including gender, medication, course of treatment, choice of three kinds of commonly used antimicrobial agents (macrolides, tetracyclines and quinolones), antimicrobial susceptibility test in the cases of ineffective or remnant bacterium after treatment, and relationship between single or combined antimicrobial application and Uu remnant was compared.Results The sensitive rate of susceptibility test of clarithromycin, doxycycline and minocycline was 92.35%, 87.76% and 86.74% respectively, while ofloxacin, levofloxacin and roxithromycin was only 12.25%, 35.71% and 37.76% respectively. Gender, medication and course of treatment affected therapeutic effect (P<0.01).In patients with Uu remnant, female patients, medication by vein, course of treatment less than seven days accounted for 83.87%,62.90% and 74.19% respectively. There was significant gender differences treated by clarithromycin in Uu remnant (P<0.01); there was a higher curing rate (98.75%) by combined medication than single medication(P<0.01).Conclusion The application of sensitive drugs, consideration of gender differences, combined medication and enough course of treatment can elevate the clearance rate of Uu in urogenital system.