头孢地嗪的临床及免疫调节作用研究.doc

头孢地嗪的临床及免疫调节作用研究 李光辉 张婴元 姬美蓉 吴菊芳 吴卫红 汪 复 摘要 为评价头孢地嗪治疗免疫缺陷者感染的疗效、安全性及免疫调节作用, 在107 例呼吸道、尿路及其他细菌感染中, 与头孢唑肟进行随机对照研究。有效率、痊愈率和细菌 清除率头孢地嗪组分别为8713% 、6118% 和8913% ; 头孢唑肟组分别为8217% 、5916% 和 9016% 。不良反应发生率头孢地嗪组512% , 头孢唑肟组714% 。头孢地嗪组治疗后 CD + 、 4 CD + ?CD + 比值升高, N K 细胞活性增强, 活化的淋巴细胞白细胞介素22受体表达增多, 对 4 8 照药头孢唑肟则无显著作用。研究结果显示, 头孢地嗪治疗免疫缺陷者感染安全有效, 并 具免疫调节作用。 关键词 头孢菌素类 细菌感染 免疫调节 CL IN ICAL EVAL UA T IO N A ND IMM UNOM OD UL A TO RY STUDY O F CEFOD IZ IM E L i G u ang h u i3 , Z h ang Y ingy u an , J i M e irong , e t a l. s ity , S h ang h a i 200040 3 I ns t itu te of A n t ibiot ics, S h ang h a i M ed ica l U n iv e r2 A bstrac t T o inve st iga te th e eff icacy, safe ty and imm unom o du la t ing ac t iv it ie s o f cefo d izim e in im 2 m uno com p rom ised p a t ien t s w ith infec t io n s, w e ca r r ied o u t a random ized co n t ro lled p ro sp ec t ive study o f cefo d izim e v s cef t izo x im e in 107 p a t ien t s. T h e to ta l effec t ive cu re ra te and bac te r ia l e rad ica t io n ra te w e re 87. 3% , 61. 8% and 89. 3% in cefo d izim e g ro up and 82. 7% , 59. 6% and 90. 6% in cef t izo x im e g ro up. D rug to le rence w a s sim ila r in th e tw o g ro up s, and side effec t w a s m ild and t ran sien t, m a in ly ga st ro in te st ina l reac t io n s. C efo d izim e h ad effec t o n bo th p h ago cy te and lym p ho cy te func t io n s: enh anc2 ing th e p h ago cy t ie ra te, p h ago cy t ic index and bac te r ia l k illing ac t iv ity, inc rea sing th e num be r o f CD + 4 lym p h acy te and th e ra t io o f CD + ?CD + , 4 8 st im u la t ing N K ce ll ac t iv ity and enh anc ing exp re ssio n o f IL 22R o f ac t ive lym p ho cy te. M eanw h ile cef t izo x im e h ad no effec t o n any o f th e p a ram e te r m en t io ned abo ve. T h e re su lt show ed th a t cefo d izim e is effec t ive and safe in th e t rea tm en t o f L R T I, upp e r and com p lica ted U T I in imm uno com p rom ised p a t i