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替考拉宁对血液系统恶性肿瘤化疗后肺部感染的临床疗效

Clinical effect of teicoplanin on pulmonary infection after chemotherapy for hematologic malignancies.

作者信息

Song Ling, Hu Yue, Yang Youwei, Xu Li

机构信息

Department of Hematology, Anhui No.2 Provincial People's Hospital Hefei, Anhui, China.

出版信息

Am J Transl Res. 2022 Oct 15;14(10):7467-7476. eCollection 2022.

Abstract

OBJECTIVE

To explore the effects of teicoplanin on pulmonary infection after chemotherapy for hematologic malignancies.

METHODS

In the present retrospective study, 64 patients with pulmonary infection, who underwent chemotherapy for hematologic malignancies at Anhui No.2 Provincial People's Hospital from September 2019 to September 2021, were selected as an infection group, and their clinical data were retrospectively analyzed. Meanwhile, 30 patients without pulmonary infection after chemotherapy for hematologic malignancies were selected as a reference group. Patients in the infection group were subdivided into control and treatment groups (n=32 each) according to the different therapeutic regimens. The control group was given routine treatment with norvancomycin, while the treatment group was given teicoplanin combined with norvancomycin. The therapeutic effects, bacterial clearance rate, recovery time, clinical pulmonary infection score (CPIS), inflammatory factors and adverse reactions were compared between the two groups. The risk factors of pulmonary infection after treatment for hematologic malignancies were analyzed.

RESULTS

The treatment group exhibited higher total therapeutic effect and higher bacterial clearance rate than the control group ( < 0.05). The treatment group had shorter time to the recovery of white blood cell (WBC) count, time to the disappearance of cough and sputum, time to return to normal body temperature, and length of stay than the control group ( < 0.05). One month post-treatment, the levels of C-reactive protein, tumor necrosis factor-α, interleukin-1β, and procalcitonin in the treatment group were lower than those in the control group ( < 0.05). The CPISs at 7, 14, and 30 days after treatment were lower in the treatment group than those in the control group ( < 0.05). Compared with the reference group, the infection group had higher rate of diabetes, higher rate of glucocorticoid use, longer time of agranulocytosis, longer hospital stay and lower WBC count ( < 0.05). Multivariate Logistic regression analysis showed that agranulocytosis time, diabetes mellitus and glucocorticoid use were independent risk factors for pulmonary infection after treatment for hematologic malignancies ( < 0.05), and that higher WBC was a protective factor ( < 0.05).

CONCLUSION

Teicoplanin in the treatment of pulmonary infection after chemotherapy for hematologic malignancies can improve the therapeutic effects, effectively clear bacteria, shorten the recovery time and reduce the inflammatory response.

摘要

目的

探讨替考拉宁对血液系统恶性肿瘤化疗后肺部感染的影响。

方法

在本回顾性研究中,选取2019年9月至2021年9月在安徽省第二人民医院接受血液系统恶性肿瘤化疗的64例肺部感染患者作为感染组,对其临床资料进行回顾性分析。同时,选取30例血液系统恶性肿瘤化疗后未发生肺部感染的患者作为参照组。根据不同治疗方案,将感染组患者分为对照组和治疗组(每组n = 32)。对照组给予去甲万古霉素常规治疗,治疗组给予替考拉宁联合去甲万古霉素治疗。比较两组的治疗效果、细菌清除率、恢复时间、临床肺部感染评分(CPIS)、炎症因子及不良反应。分析血液系统恶性肿瘤治疗后肺部感染的危险因素。

结果

治疗组的总治疗效果和细菌清除率均高于对照组(P < 0.05)。治疗组白细胞(WBC)计数恢复时间、咳嗽咳痰消失时间、体温恢复正常时间及住院时间均短于对照组(P < 0.05)。治疗后1个月,治疗组C反应蛋白、肿瘤坏死因子-α、白细胞介素-1β及降钙素原水平低于对照组(P < 0.05)。治疗后7、14和30天,治疗组的CPIS低于对照组(P < 0.05)。与参照组相比,感染组糖尿病发生率更高、糖皮质激素使用率更高、粒细胞缺乏时间更长、住院时间更长且WBC计数更低(P < 0.05)。多因素Logistic回归分析显示,粒细胞缺乏时间、糖尿病和糖皮质激素使用是血液系统恶性肿瘤治疗后肺部感染的独立危险因素(P < 0.05),而较高的WBC是保护因素(P < 0.05)。

结论

替考拉宁治疗血液系统恶性肿瘤化疗后肺部感染可提高治疗效果,有效清除细菌,缩短恢复时间并减轻炎症反应。

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