奈替米星及阿米卡星治疗下呼吸道感染临床疗效比较.docVIP

奈替米星及阿米卡星治疗下呼吸道感染临床疗效比较 　【摘要】 目的 以阿米卡星为对照评价奈替米星治疗下呼吸道感染的临床有效性及安全性。方法 共入选病例132例，可评价疗效者102例，其中试验组(奈替米星)与对照组(阿米卡星)分别为52例与50例。安全性评价入选病例113例，两组分别为56例与57例。给药方法试验组每次200mg，每日1次，对照组每次200mg，每日2次，两组疗程均为7～14天。结果 试验组与对照组的临床有效率分别为84.61%与64.00%，细菌清除率分别为90.91%与66.67%，敏感菌百分率分别为93.18%与71.43%，听力下降发生率分别为1.79%与15.79%。以上结果经统计学处理两组差异有显著性。结论 奈替米星为治疗下呼吸道感染的安全、有效的抗菌药物。 【关键词】 下呼吸道感染;奈替米星;阿米卡星;随机对照试验 　　ABSTRACT Objective To evaluate the clinical effectiveness and safety of netilmicin (NET) with amikacinin (ANK) as the control in the treatment of lower respiratory tract infection. Methods 130 cases were enrolled in this study; curative effect evaluation was made in 102 cases (52 cases for NET and 50 cases for ANK) while safety evaluation was made in 1113 cases (56 cases for NET and 57 cases for ANK); NET was administrated once a day at the dose of 200mg and the course lasted for 7 to 14 days while ANK was administrated twice a day at the dose of 200mg each time and the course lasted for 7 to 14 days. Results The clinical effective rate was 84.61% of NET and 64.00% of ANK; the bacterial clearance rate was 90.91% of NET and 66.67% of ANK; the bacterial susceptibility rate was 93.18% of NET and 71.43% of ANK; the incidence of hearing loss was 1.79% of NET and 15.79 % of ANK; the statistical study indicated a difference of significance between the two drugs. Conclusions NET is an effective and safe antibiotic for lower respiratory tract infection. 　　KEYWORDS randomized controlled trial lower respiratory tract infection 　　Netilmicin amikacin 　　奈替米星(netilmicin)是一种半合成氨基糖苷类抗生素。本品具有抗菌谱广，对革兰阴性杆菌及葡萄菌具有较高的抗菌活性，对氨基糖苷类灭活酶稳定，血药峰浓度高，半衰期长，抗生素后效应强，耳毒性、肾毒性低等特点[1～5] 。现将奈替米星与阿米卡星(amikacin)治疗下呼吸道感染疾病的比较报告如下。 　　1 资料与方法 　　1.1 一般资料 全部病例均为2004年1～12月住我院呼吸内科病房患者，征得受试者知情同意，共入选132例; 年龄20～74岁，性别不限;其临床症状、体征、实验室检查均符合急性下呼吸道感染诊断标准;48h 内未接受有效的抗生素治疗，80%以上病例有细菌学诊断证实;无氨基糖苷类抗生素过敏史或过敏反应者;无心、肺、肝、肾及造血、神经系统严重合并症;无听力、前庭功能障碍者。 　　本组临床试验中，试验组(奈替米星)与对照组(阿米卡星)进入试验病例分别为68例与64例，因不符合试验设计要求淘汰分别为12例与7例，耐药菌淘汰分别为3例与2例，因不良反应被迫