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目的观察奈替米星治疗高龄感染患者的安全性。方法选取急诊病房高龄感染患者40例,治疗前血清肌酐(Scr)均在正常范围内,内生肌酐清除率(Ccr)≥60 ml/min(按Cockcroft-Gault公式计算)。以奈替米星冻干粉针4 mg/(kg.d)加入糖水或盐水静脉滴注。感染一经确诊首先使用青霉素类、β-内酰胺类或大环内酯等抗菌药物治疗,3 d后如疗效不明显,则加用奈替米星联合治疗。于治疗前后检测尿微量白蛋白(MA)、尿α1-微球蛋白(Uα1-MG),奈替米星应用至稳态后检测其血谷浓度和峰浓度。抗生素使用前取痰、尿或褥疮分泌物做细菌学培养。结果Scr、Ccr、MA和Uα1-MG治疗前后差异无统计学意义。结论选择适宜人群,监测有效指标,准确评估老年人肾功能水平,联合应用抗生素奈替米星治疗高龄感染患者有效且安全。
Objective To observe the safety of netilmicin in the treatment of elderly patients. Methods Forty patients with advanced infection in emergency ward were selected. The serum creatinine (Scr) before treatment was within the normal range and the creatinine clearance rate (Ccr) was ≥60 ml / min (calculated according to Cockcroft-Gault formula). To netilmicin freeze-dried powder 4 mg / (kg.d) by adding sugar or saline intravenous drip. Once the diagnosis of infection first use of penicillins, β-lactams or macrolide antibacterial drugs, such as 3 d after the effect is not obvious, then add netilmicin combination therapy. Urine microalbumin (MA), urinary α1-microglobulin (Uα1-MG) and netilmycin were detected before and after treatment. Antibiotics before taking sputum, urine or bedsores secretions do bacteriological training. Results There was no significant difference in Scr, Ccr, MA and Uα1-MG before and after treatment. Conclusion Choosing the right population, monitoring effective indicators, accurately evaluating the renal function of the elderly, combined with antibiotics netilmicin in the treatment of elderly patients with effective and safe.