抗菌药物治疗细菌性肺炎疗效指标及标准分析.doc

抗菌药物治疗细菌性肺炎疗效指标及标准分析 　 作者：王至婉 李建生 余学庆 张艳霞 田玉收 李亚 秦金利 【摘要】 目的 分析抗菌药物治疗细菌性肺炎的疗效评价指标和标准，为该病疗效评价标准的建立提供依据。方法 计算机检索CNKI(1994～2007.6)和CBM(1995～2007.6)所收录的相关文献，建立相应的数据库，采用SPSS13.0统计软件包进行统计描述。结果 收集合格文献481篇。抗菌药物治疗细菌性肺炎疗效评价指标中综合指标出现的频率最高(98.5%)，其次是不良反应发生率(84.4%)和细菌清除率(66.1%)，其它指标出现的频率较低。综合指标的疗效评价标准主要依据《抗菌药物临床研究指导原则》，其构成比为54.1%。结论 目前国内对于细菌性肺炎疗效指标的研究多采用综合指标、细菌清除率和不良反应发生率，而单独以临床症状和体征作为疗效评价指标的较少，以病情稳定性、再住院率和基于患者结果的报告作为疗效评价指标在检索的文献中尚未见报道。 【关键词】 抗菌药物； 细菌性肺炎； 疗效指标； 疗效标准 ABSTRACT Objective To study the therapeutic effect index and criterion in the treatment of bacterial pneumonia with antiinfective drug. Method Literatures concerning bacterial pneumonia were identified from CNKI (1994～2007.6) and CBM (1995～2007.6). SPSS for windows ver.13.0 was adopted for statistical description. Results Four hundred eighty one literatures were included. Frequency of comprehensive index was the topmost at all indexes of therapeutic effect evaluation (98.5%), followed by frequency of adverse reaction rate and bacterial clearance rate, which were 84.4% and 66.1%, respectively. Evaluation critetion of the comprehensive index mainstaied instruction principle on antibacterials clinical research, the constituent ratio was 51.4%. Conclusion Among indexes of therapeutic effect evaluation at present in China, comprehensive index, adverse reaction rate and bacterial clearance rate were used more often, but clinical symptoms and signs were less reported, and report based on the final outcomes, therapeutic stability and readmission rate relating to efficacy evaluation indices was not recorded in the retrieval literatures. KEY WORDS Antiinfective drug; Bacterium pneumonia; Therapeutic effect index; Therapeutic effect criterion 肺炎是一种临床常见病，严重危害着人们的健康，影响着人们的生活质量，给患者造成沉重的疾病负担。虽然引起肺炎的病原体有细菌、真菌、衣原体、病毒等微生物，但细菌仍是肺炎最常见的病原体。目前对其治疗多以西药为主，抗菌药物的治疗已成为公认的标准疗法。本研究着眼于细菌性肺炎的抗感染治疗疗效评价指标和标准，对其分析与再评价，旨在为该病疗效评价标准的建立提供依据。 1 资料与方法 1.1 文献资料来源 中国生物医学文献数据库(CBM，1995年～2007年6月)和中国学术期刊全文数据库(CNKI，1994年～2007年6月)所收录的全部文献。 1.2 纳入标准 具有明