利奈唑胺补救治疗成人革兰阳性菌感染性心内膜炎的临床分析

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目的：通过临床病例回顾性研究，评价利奈唑胺补救治疗成人革兰阳性菌(G+)感染性心内膜炎(IE)的临床疗效及安全性。方法：收集南京医科大学附属南京医院感染科在2008年1月~2012年12月期间收治的确诊G+菌感染所致IE患者36例，其中利奈唑胺治疗组15例(以下简称为L组)，其他抗感染药物治疗组21例(以下简称对照组)；分析两组患者一般情况，比较两组患者治疗效果以及预后，数据处理通过SPSS软件。结果：两组患者均取得较好的疗效，L组与对照组的病死率分别为6.7%(1例)和9.5%(2例)，预后亦无显著性差异(P > 0.05)；L组仅1例患者出现血小板下降的不良反应，停药后即好转，其他患者均耐受良好。结论：利奈唑胺用于G+菌IE的治疗可获得良好疗效，而且耐受性好。对多重耐药G+菌引起的IE，尤其对传统疗法有禁忌或治疗失败，是一个极具优势的治疗选择。 Objective: Retrospective study was carried out to evaluate the efficacy and safety of Linezolid as rescue treatment for adult gram-positive bacterial infective endocarditis. Methods: The study comprised 36 patients from department of infectious disease in Nanjing hospital affiliated to Nanjing Medical University, between 2008 and 2012. Fifteen patients enrolled in L group received Linezolid as rescue treatment for infective endocarditis which were unsuccessfully treated. Other twenty-one patients received conventional antibiotic therapy (Control group). We described baseline characteristics of the study population and compared L group with control group for the efficacy and the safety of treatment. The data were analyzed by SPSS software. Results: The thirty-three patients in two groups received effective treatment. No significant differences in the cure rate (80% vs. 81%) and in mortality (6.7% vs. 9.5%) were observed. Thrombocytopenia was present in only one patient of L group, and others were well tolerated. When we ended the Linezolid for treatment, the patients get well from thrombocytopenia. Conclusions: Linezolid was well tolerated and associated with the effective outcome as in patients with IE due to multiple resistant gram-positive, especially in patients who are fail to treated with conventional therapy or are poorly tolerated.