头孢他啶-阿维巴坦治疗碳青霉烯耐药革兰氏阴性杆菌感染引起的重症肺炎患者的疗效及安全性分析<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2026.01.002

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摘要 【目的】 探讨头孢他啶-阿维巴坦(ceftazidime-avibactam,CAZ-AVI)治疗碳青霉烯耐药革兰氏阴性杆菌(carbapenem-resistant organism,CRO)感染引起的重症肺炎患者的疗效及安全性。【方法】 选取2019年9月至2020年10月本院收治的71例CRO感染引起的重症肺炎患者,其中38例接受以CAZ-AVI为基础的联合治疗方案,纳入CAZ-AVI组,33例接受CAZ-AVI以外的抗CRO联合治疗方案,纳入对照组。比较两组患者抗感染治疗前后的白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、急性生理学和慢性健康状况评价Ⅱ(APACHE Ⅱ)评分、序贯器官衰竭评估(SOFA)评分,抗生素使用时间、机械通气时间、入住呼吸重症监护病房(RICU)时间、RICU生存率、28 d生存率及不良反应发生情况。【结果】 治疗后,CAZ-AVI组患者WBC、CRP、PCT及IL-6水平明显低于对照组(P<0.05),APACHEⅡ评分及SOFA评分明显低于对照组(P<0.05)。CAZ-AVI组色素沉着发生率明显低于对照组(P<0.05),抗感染治疗时间及机械通气时间短于对照组(P<0.05),RICU生存率及28 d生存率高于对照组(P<0.05)。【结论】 对CRO感染引起的重症肺炎患者,予以CAZ-AVI为基础的联合治疗方案更有效、更安全,且存活率更高,具有良好的临床应用前景。

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	张瑞霞
	张晓珊
	李双凤

关键词 ：肺炎, 头孢他啶, β-内酰胺酶抑制剂, 抗药性,细菌, 治疗结果

Abstract：【Objective】 To investigate the efficacy and safety of ceftazidime-avibactam(CAZ-AVI) in the treatment of patients with severe pneumonia caused by carbapenem-resistant organism(CRO) infection. 【Methods】 A total of 71 patients with severe pneumonia caused by CRO infection admitted to our hospital from September 2019 to October 2020 were selected. Among them, 38 cases received CAZ-AVI-based combined therapy and were included in the CAZ-AVI group, and 33 cases received anti-CRO combined therapy except CAZ-AVI and were included in the control group. The white blood cell count(WBC), C-reactive protein(CRP), procalcitonin(PCT), interleukin-6(IL-6), Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) score, Sequential Organ Failure Assessment(SOFA) score before and after anti-infective treatment, duration of antibiotic use, mechanical ventilation time, length of stay in respiratory intensive care unit(RICU), RICU survival rate, 28-day survival rate and incidence of adverse reactions were compared between the two groups. 【Results】 After treatment, the levels of WBC, CRP, PCT and IL-6 in the CAZ-AVI group were significantly lower than those in the control group(P<0.05), and the APACHE Ⅱ score and SOFA score were significantly lower than those in the control group(P<0.05). The incidence of hyperpigmentation in the CAZ-AVI group was significantly lower than that in the control group(P<0.05). The duration of anti-infective treatment and mechanical ventilation time in the CAZ-AVI group were shorter than those in the control group(P<0.05), and the RICU survival rate and 28-day survival rate were higher than those in the control group(P<0.05). 【Conclusion】 For patients with severe pneumonia caused by CRO infection, CAZ-AVI-based combined therapy is more effective and safer, with higher survival rate, which has a good clinical application prospect.

Key words： Pneumonia Ceftazidime Beta-Lactamase Inhibitors Drug Resistance, Bacterial Treatment Outcome

收稿日期: 2025-07-23

中图分类号:

R563.1

基金资助:*河南省医学科技攻关计划联合共建项目(LHGJ20200772);河南省科技攻关项目(182102310177);河南省高等学校重点科研项目计划(18A320012)

引用本文:

张瑞霞, 张晓珊, 李双凤. 头孢他啶-阿维巴坦治疗碳青霉烯耐药革兰氏阴性杆菌感染引起的重症肺炎患者的疗效及安全性分析^*[J]. 医学临床研究, 2026, 43(1): 5-8.
ZHANG Ruixia, ZHANG Xiaoshan, LI Shuangfeng. Efficacy and Safety Analysis of Ceftazidime-Avibactam in the Treatment of Severe Pneumonia Caused by Carbapenem-Resistant Gram-Negative Bacilli Infection. JOURNAL OF CLINICAL RESEARCH, 2026, 43(1): 5-8.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.01.002 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I1/5

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