浏览全部资源
扫码关注微信
不同剂量美罗培南治疗脓毒症休克的临床效果比较 Δ
Comparison of clinical effects of different doses of meropenem in the treatment of septic shock
- 中国药房 2024年35卷第13期 页码：1624-1627
- 作者机构：
1.衡水市人民医院药学部，河北 衡水 053000
2.衡水市人民医院重症医学科，河北 衡水 053000
3.衡水市人民医院输血科，河北 衡水 053000
4.衡水市人民医院检验科，河北 衡水 053000
- 作者简介：
主管药师。研究方向：合理用药。E-mail：pingze1018@163.com
- 基金信息：河北省科技计划项目(2022HBKJ00029);河北省医学科学研究课题(20210910)
DOI：10.6039/j.issn.1001-0408.2024.13.14
中图分类号： R969纸质出版日期：2024-07-15，
收稿日期：2023-10-27，
修回日期：2024-05-16，
- 稿件说明：
扫 描 看 全 文
平泽,张建军,王金荣等.不同剂量美罗培南治疗脓毒症休克的临床效果比较 Δ[J].中国药房,2024,35(13):1624-1627.
PING Ze,ZHANG Jianjun,WANG Jinrong,et al.Comparison of clinical effects of different doses of meropenem in the treatment of septic shock[J].ZHONGGUO YAOFANG,2024,35(13):1624-1627.
平泽,张建军,王金荣等.不同剂量美罗培南治疗脓毒症休克的临床效果比较 Δ[J].中国药房,2024,35(13):1624-1627. DOI： 10.6039/j.issn.1001-0408.2024.13.14.
PING Ze,ZHANG Jianjun,WANG Jinrong,et al.Comparison of clinical effects of different doses of meropenem in the treatment of septic shock[J].ZHONGGUO YAOFANG,2024,35(13):1624-1627. DOI： 10.6039/j.issn.1001-0408.2024.13.14.
摘要
目的
2
比较不同剂量美罗培南治疗脓毒症休克的临床效果。
方法
2
将106例脓毒症休克患者按随机数字表法分为标准剂量组和高剂量组，每组53例。标准剂量组患者予以标准剂量美罗培南（首次静脉滴注美罗培南1 g，持续30 min以上，然后每8 h静脉滴注美罗培南1 g，每次3 h以上）；高剂量组患者予以高剂量美罗培南（首次静脉滴注美罗培南2 g，持续30 min以上，然后每8 h静脉滴注美罗培南2 g，每次3 h以上）；其余治疗措施根据患者具体情况而定。主要观察指标为两组患者治疗3、5、7 d时的序贯器官衰竭估计（SOFA）评分和简化的急性生理评分Ⅱ（SAPS Ⅱ）的增量。次要观察指标为两组患者的院内死亡率，90 d全因病死率，7 d微生物治愈率，7 d临床治愈率，治疗3、5、7 d时的血清降钙素原（PCT）和C反应蛋白（CRP）水平，重症监护室住院天数，呼吸机治疗天数，去甲肾上腺素最高剂量。同时观察两组患者的不良反应发生情况。
结果
2
高剂量组患者治疗7 d时的SOFA评分增量、SAPS Ⅱ增量，治疗5、7 d时的PCT、CRP水平以及90 d全因病死率均显著低于标准剂量组（
P
＜0.05）。两组间其他指标比较，差异均无统计学意义（
P
＞0.05）。
结论
2
高剂量美罗培南治疗脓毒症休克相比标准剂量美罗培南具有更好的临床效果，且安全性较好。
Abstract
OBJECTIVE
2
To compare the clinical effects of different doses of meropenem in the treatment of septic shock.
METHODS
2
One hundred and six patients with septic shock were randomly divided into standard-dose group and high-dose group， with 53 cases in each group. Patients in the standard-dose group were given standard dose of meropenem （initial intravenous injection of 1 g meropenem more than 30 minutes， followed by 1 g meropenem intravenously every 8 hours， each time for more than 3 hours）； patients in the high-dose group were given high dose of meropenem （initial intravenous injection of 2 g meropenem more than 30 minutes， followed by 2 g meropenem intravenously every 8 hours， each time for more than 3 hours）； other treatment measures were determined based on the specific conditions of the patients. The main observation indicators were the increments of sequential organ failure assessment （SOFA） scores and simplified acute physiology score Ⅱ （SAPS Ⅱ） after 3， 5 and 7 days of treatment in both groups. Secondary observation indicators included in-hospital mortality， 90-day all-cause mortality， 7-day microbial cure rate， 7-day clinical cure rate， serum procalcitonin （PCT） and C-reactive protein （CRP） levels after 3， 5 and 7 days of treatment， hospitalization days in the intensive care unit， ventilator treatment days， the highest dose of norepinephrine. The occurrence of adverse drug reaction in the two groups was observed.
RESULTS
2
The increments of SOFA scores and SAPS Ⅱ after 7 days of treatment， the levels of PCT and CRP after 5 and 7 days of treatment as well as the 90-day all-cause mortality in the high-dose group were significantly lower than the standard-dose group （
P
＜0.05）. There were no statistically significant differences in other indicators between the two groups （
P
＞0.05）.
CONCLUSIONS
2
High-dose meropenem treatment for septic shock has better clinical effects and is safer than standard-dose meropenem.
关键词
脓毒症休克美罗培南剂量临床效果
Keywords
meropenemdoseclinical effect
references
GUARINO M，PERNA B，CESARO A E，et al. 2023 update on sepsis and septic shock in adult patients：management in the emergency department[J]. J Clin Med，2023，12（9）：3188.
EVANS L，RHODES A，ALHAZZANI W，et al. Survi- ving sepsis campaign：international guidelines for management of sepsis and septic shock 2021[J]. Intensive Care Med，2021，47（11）：1181-1247.
HOWELL M D，DAVIS A M. Management of sepsis and septic shock[J]. JAMA，2017，317（8）：847-848.
BOONPENG A，JARURATANASIRIKUL S，JULLANGKOON M，et al. Population pharmacokinetics/pharmacodynamics and clinical outcomes of meropenem in critically ill patients[J]. Antimicrob Agents Chemother，2022，66（11）：e0084522.
YE X L，WANG F，ZENG W Q，et al. Comparison of empirical high-dose and low-dose of meropenem in critically ill patients with sepsis and septic shock：a randomized controlled study protocol[J]. Medicine，2020，99（51）：e22829.
TROISI C，COJUTTI P G，RINALDI M，et al. Measuring creatinine clearance is the most accurate way for calcula- ting the proper continuous infusion meropenem dose for empirical treatment of severe gram-negative infections among critically ill patients[J]. Pharmaceutics，2023，15（2）：551.
ROGGEVEEN L F，GUO T J，FLEUREN L M，et al. Right dose，right now：bedside，real-time，data-driven，and personalized antibiotic dosing in critically ill patients with sepsis or septic shock：a two-centre randomized clinical trial[J]. Crit Care，2022，26（1）：265.
MORENO R，RHODES A，PIQUILLOUD L，et al. The sequential organ failure assessment （SOFA） score：has the time come for an update?[J]. Crit Care，2023，27（1）：15.
YANG J M，CHEN J，ZHANG M，et al. Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients：a retrospective cohort study[J]. BMC Infect Dis，2024，24（1）：197.
BARANOWSKY A，APPELT J，KLEBER C，et al. Procalcitonin exerts a mediator role in septic shock through the calcitonin gene-related peptide receptor[J]. Crit Care Med，2021，49（1）：e41-e52.
SCHUPP T，WEIDNER K，RUSNAK J，et al. C-reactive protein and procalcitonin during course of sepsis and septic shock[J]. Ir J Med Sci，2024，193（1）：457-468.
LERTWATTANACHAI T，MONTAKANTIKUL P，TANGSUJARITVIJIT V，et al. Clinical outcomes of empirical high-dose meropenem in critically ill patients with sepsis and septic shock：a randomized controlled trial[J]. J Intensive Care，2020，8：26.
0
浏览量
1
下载量
0
CSCD
- 网络PDF下载
- WORD下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 地址：重庆市渝中区大坪正街129号四环大厦8层 邮编：400042
- 技术支持由北京北大方正电子有限公司提供 渝ICP备15012710号
公网安备50010302001817 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies