替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌感染性心内膜炎的疗效观察

蒋希萌; 田东华; 王晓莉; 张金盈

doi:10.16016/j.1000-5404.201911097

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替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌感染性心内膜炎的疗效观察

临床医学 | 更新时间：2026-01-09

- 替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌感染性心内膜炎的疗效观察
- Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis
- 第三军医大学学报 2020年42卷第7期页码：714-719
- 作者机构：
  
  100027 北京，武警北京总队医院内二科
- 作者简介：
  
  [ 蒋希萌. E-mail:jmengmeng1211@163.com Jiang Ximeng, E-mail:jmengmeng1211@163.com
- 基金信息：
  
  国家自然科学基金面上项目(81570274)
- DOI：10.16016/j.1000-5404.201911097
  中图分类号： R542.41; R977.22; R978.1
- 收稿：2019-11-12，
  
  修回：2019-12-03，
  
  纸质出版：2020-04-15
- 稿件说明：
移动端阅览
蒋希萌, 田东华, 王晓莉, 等. 替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌感染性心内膜炎的疗效观察[J]. 第三军医大学学报, 2020,42(7):714-719.

Ximeng JIANG, Donghua TIAN, Xiaoli WANG, et al. Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis[J]. Journal of Third Military Medical University, 2020, 42(7): 714-719.
蒋希萌, 田东华, 王晓莉, 等. 替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌感染性心内膜炎的疗效观察[J]. 第三军医大学学报, 2020,42(7):714-719. DOI： 10.16016/j.1000-5404.201911097.

Ximeng JIANG, Donghua TIAN, Xiaoli WANG, et al. Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis[J]. Journal of Third Military Medical University, 2020, 42(7): 714-719. DOI： 10.16016/j.1000-5404.201911097.

摘要

目的

观察替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌(methicillin-resistant

Staphylococcus aureus

，MRSA)感染性心内膜炎(infective endocarditis，IE)的临床疗效。

方法

选取2018年3月至2019年2月本院收治的84例MRSA所致IE患者，采用随机数字表法分为对照组(替考拉宁+安慰剂治疗)和联合用药组(替考拉宁+左卡尼汀治疗)，每组42例；观察治疗前后心功能指标变化；评估2组临床疗效及细菌清除情况；对比分析治疗前后2组血清超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)水平及白细胞计数(WBC)、红细胞沉降率(ESR)；观察2组治疗期间不良反应发生情况。

结果

治疗前2组心功能指标比较，差异均无统计学意义(

0.05)；治疗后联合用药组SV、CO、LVEF均显著高于对照组(

0.05)。2组临床疗效等级分布比较，差异有统计学意义(

0.05)，其中联合用药组总有效率(95.24%)显著高于对照组(80.95%

0.05)，清除率(92.86%)及总清除率(97.62%)均显著高于对照组(76.19%、83.33%

0.05)；治疗前2组血清hs-CRP、PCT水平及WBC、ESR比较，差异均无统计学意义(

0.05)；治疗后2组血清hs-CRP、PCT水平及WBC、ESR均降低，且联合用药组均显著低于对照组(

0.05)；2组总体不良反应发生率比较，差异无统计学意义(

0.05)。

结论

替考拉宁联合左卡尼汀可有效改善MRSA所致IE患者心功能，提高细菌清除率，且能有效控制感染，安全可靠。

Abstract

Objective

To observe the clinical efficacy of teicoplanin combined with levocarnitine in treatment of methicillin-resistant

Staphylococcus aureus

(MRSA) infective endocarditis (IE).

Methods

A total of 84 patients diagnosed with IE caused by MRSA admitted to our hospital from March 2018 to February 2019 were perspectively recruited

and then randomly divided into control group (teicoplanin and placebo) and combined treatment group (teicoplanin and levocarnitine)

42 cases in each group. Cardiac function indexes

including stroke output (SV)

cardiac output (CO) and left ventricular ejection fraction (LVEF) were observed before and after treatment. The clinical efficacy and bacterial clearance were evaluated and compared between the 2 groups. The levels of hypersensitivity C-reaction protein (hs-CRP) and procalcitonin (PCT)

white blood cell count (WBC)

and erythrocyte sedimentation rate (ESR) in the serum of the 2 groups before and after treatment were compared. Adverse reactions during treatment were counted and compared.

Results

There were no significant differences in cardiac function indexes between the 2 groups before treatment (

0.05). While

CO and LVEF were increased after treatment in both groups

and the above values in the combined group were significantly higher than those of the control group (

0.05). Statistical difference was seen in the distribution of efficacy grade between the 2 groups (

0.05)

and the combination group had notably higher total effective rate (95.24%

80.95%)

clearance rate (92.86%

76.19%) and total clearance rate (97.62%

83.33%) when compared with the control group (all

0.05). There were no significant differences in serum hs-CRP and PCT levels and WBC and ESR before treatment (

0.05). The indexes were decreased after treatment

with those in the combined group more significant (all

0.05). No significant difference was found in the incidence of total adverse reactions between the 2 groups (

0.05).

Conclusion

Teicoplanin combined with L-carnitine is safe and reliable

and can effectively improve the cardiac function

promote bacterial clearance rate

and effectively control infection in IE patients induced by MRSA.

关键词

Keywords

references

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