替加环素治疗感染性疾病临床疗效及影响因素

doi:10.6040/j.issn.1671-7554.0.2024.0181

摘要/Abstract

摘要： 目的探讨替加环素治疗感染性疾病的临床疗效和影响因素。方法回顾性收集山东第一医科大学附属省立医院2017年1月至2020年12月应用替加环素住院患者的病历746份,分析临床资料特征,评价临床疗效及影响因素。结果本研究纳入有效病例726例,感染以呼吸系统感染(65.43%)和复杂性腹腔内感染(complicated intra-abdominal infection, cIAI)(27.13%)为主。临床有效率约为65.70%,不良反应发生率约为4.68%。Logistic回归分析显示应用替加环素治疗无效的危险因素为恶性实体肿瘤(OR=1.931, 95%CI: 1.161~3.214, P=0.011)、呼吸系统感染(OR=1.704, 95%CI: 1.096~2.649, P=0.018)、感染性休克(OR=2.784, 95%CI: 1.766~4.389, P<0.001)、呼吸机辅助通气(OR=1.809, 95%CI: 1.143~2.862, P=0.011)和应用连续肾脏替代治疗(continuous renal replacement therapy, CRRT)(OR=1.886, 95%CI: 1.136~3.129, P=0.014);而入住ICU(OR=0.518, 95%CI: 0.309~0.870, P=0.013)、长用药疗程(OR=0.952, 95%CI: 0.919~0.985, P=0.005)是治疗的保护因素。结论替加环素适用于病情危重、多重耐药菌所致的复杂难治性感染,患者合并恶性实体肿瘤、呼吸系统感染、感染性休克、呼吸机辅助通气和CRRT时治疗无效危险性更高,需慎重使用并加强治疗监护。

关键词: 细菌感染, 替加环素, 临床疗效, 影响因素

Abstract: Objective To investigate the clinical efficacy and influencing factors of tigecycline in the treatment of infectious diseases. Methods A total of 746 medical records of patients treated with tigecycline in Shandong Provincial Hospital Affiliated to Shandong First Medical University during January 2017 and December 2020 were retrospectively collected, and the clinical data of patients were analyzed to evaluate the clinical efficacy and factors. Results This study included 726 valid cases. Respiratory infection(65.43%)and complicated intra-abdominal infection(cIAI)(27.13%)were the main infections. The clinical effective rate was 65.70%, and the incidence of adverse reactions was 4.68%. Logistic regression analysis showed that the risk factors for the failure of tigecycline treatment were malignant solid tumor(OR=1.931, 95%CI: 1.161-3.214, P=0.011), respiratory system infection(OR=1.704, 95%CI: 1.096-2.649, P=0.018), septic shock(OR=2.784, 95%CI: 1.766-4.389, P<0.001), mechanical ventilation(OR=1.809, 95%CI: 1.143-2.862, P=0.011)and continuous renal replacement therapy(CRRT)(OR=1.886, 95%CI: 1.136-3.129, P=0.014), while the protective factors were admission to ICU(OR=0.518, 95%CI: 0.309-0.870, P=0.013)and long duration(OR=0.952, 95%CI: 0.919-0.985, P=0.005). Conclusion Tigecycline is mainly used for the treatment of severe and complex infections caused by multidrug-resistant bacteria. Patients with malignant solid tumor, respiratory system infection, septic shock, mechanical ventilation and CRRT have higher risk of tigecycline treatment failure, which should be paid attention to during the treatment.

Key words: Bacterial infection, Tigecycline, Clinical efficacy, Influencing factors

中图分类号:

R453.2

冯绪强,高萍,孙超,陶琳,闫根全,冷冰. 替加环素治疗感染性疾病临床疗效及影响因素[J]. 山东大学学报 (医学版), 2024, 62(12): 11-20.

FENG Xuqiang, GAO Ping, SUN Chao, TAO Lin,YAN Genquan, LENG Bing. Clinical efficacy and influencing factors of tigecycline in treatment of infectious diseases[J]. Journal of Shandong University (Health Sciences), 2024, 62(12): 11-20.

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