利奈唑胺治疗革兰氏阳性菌导管相关性菌血症的临床评价

目的：评估利奈唑胺治疗革兰氏阳性菌导管相关性菌血症的疗效和安全性。方法以2009年1月-2013年10月在我院重症医学科住院、确诊为革兰氏阳性菌导管相关性菌血症的患者为研究对象，随机分成两组（利奈唑胺组和万古霉素组），分别予利奈唑胺注射液600mg或万古霉素注射液1.0g静脉滴注，每12h 1次，连用14d，比较两种药物的临床疗效及不良反应。结果利奈唑胺组退热时间较万古霉素组短（P〈0.05）；两组痊愈率、有效率、细菌清除率无统计学差异（P〉0.05）；治疗前后两组的白细胞计数、中性粒细胞比例、C-反应蛋白、降钙素原均下降，但两组比较无显著性差异（P〉0.05）；利奈唑胺不良反应少于万古霉素（P〈0.05）。结论利奈唑胺治疗革兰氏阳性菌导管相关性菌血症疗效显著，安全性好。

A clinical study of Linezolid in treatment of catheter-associated bloodstream infections by gram-positive bacteria

Objective To evaluate the efficacy and safety of Linezolid in treatment of catheter-associated bloodstream infec-tions by gram-positive bacteria. Methods Patients diagnosed catheter-associated bloodstream infections by gram-positive bacteria between January 2009 and October 2013 were collected and allocated to receive one of two drugs,Linezolid 1200mg/day or van-comycin 2000mg/day given in two divided doses for 14 days. Clinical efficacy and adverse reactions were compared. Results Fever clearance time of Linezolid was shorter than that of Vancomycin（P〈0.05）;There were no significant differences in the clinic cure rates,clinical efficacy rates and the bacterial clearance rates between the two groups （P〉0.05）;after treatment white blood cell count,neutrophil ratio,C-reactive protein,calcitonin all declined,but there were no significant differences between the two groups （P〉0.05）;adverse reactions of Linezolid were lower than that of Vancomycin （P〈0.05）. Conclusion Linezolid has an ex-cellent clinical efficacy and good safety proflie in treating patients with catheter-associated bloodstream infections by gram-posi-tive bacteria.