资源描述：
《阿奇霉素对肺炎衣原体感染及冠心病 (2).pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、·730·ChinJNosocomiolVol.14No.72004·论 著·阿奇霉素对肺炎衣原体感染及冠心病二级预防的临床研究李 涛,吴正林,许香广,张国良,黄建平,胡雪松,李 松,吴剑胜,方卫华(深圳市福田人民医院,广东深圳518033)摘要:目的 探讨阿奇霉素长期小剂量应用对冠心病二级预防的作用。方法 选择符合冠心病诊断标准的180例患者,其中无症状型冠心病75例,不稳定型心绞痛53例,急性心肌梗死52例,采用随机双盲安慰剂对照的方法,按随机数字表分为阿奇霉素治疗组及安慰剂对照组,两组药物的药品包装名均为阿奇霉素。结果 180例患者中89例纳入阿奇霉素组,随访1年,13例出现冠心事
2、件,发生率14.6%,安慰剂组91例27例出现冠心事件,发生率29.7%,阿奇霉素组冠心事件发生率低于安慰剂组,减少了15.1%,OR0.405,95%的CI0.193～0.85;阿奇霉素组有4例因出现上腹痛、恶心退出研究,3例出现腹胀、恶心但程度轻,能耐受,副作用发生率为7.9%,安慰剂组有6例出现腹胀,2例不能耐受,退出研究,副作用发生率为6.6%,两组间差异无显著性;两组治疗前后IgG抗体滴度及各组治疗后抗体滴度的差值比较差异无显著性。结论 研究结果表明阿奇霉素能减少冠心病的症状发生,对冠心病二级预防有一定疗效,长期小剂量应用安全、耐受性好,但随访治疗前后及治疗后IgG抗体滴度无变
3、化。关键词:肺炎衣原体;微量免疫荧光抗体;冠心病;阿奇霉素;二级预防中图分类号:R978.1文献标识码:A文章编号:100524529(2004)0720730204Low-doseUsageofAzithromycinforSecondaryPreventioninPatientswithCoronaryHeartDisease:ADoubleBlindRandomizedStudyLITao,WUZheng2lin,XUXiang2guang,ZHANGGuo2liang,HUANGJian2ping,HUXue2song,LISong,WUJian2sheng,FANGWei2hu
4、a(ShenzhenFutianHospital,Shenzhen518033,China)Abstract:OBJECTIVEToobservetheclinicaleffectofusageofazithromycinwithdoubleblindrandomized,low2doseandlongtermmannerandwhetherantibioticshaveaprotectiveroleincoronaryheartdisease.METH2ODSAtotalof180patientswererandomlyallocatedtoreceiveplaceboorazithr
5、omycin.Therewere0.25gdailyforonemonth;0.25gtwiceweeklyfortwomonths;0.25gonceweeklyforthreemonths.Patientswerefol2lowedupatbaseline,weeks1and4whilereceivingtherapyandthenevery3monthsforoneyear.Thecoronaryarteryeventsincludedrecurrentischemianecessitatingrevascularization,cardiovasculardeath,recurr
6、entmyocar2dialinfarction,suddendeath,congestiveheartfailure,resuscitatedcardiacarrestwererecordedandserologyofChlamydiapneumoniae2specificIgGantibodieswasmeasuredbymicroimmunofluorescencetest.RESULTSThecoronaryarteryeventsweredecreasedinazithromycingroupcomparedwithplaceboonefrom29.7%to14.6%.Thea
7、zithromycinwasgenerallywelltolerated.Therateofsideeffectswas7.9%withazithromycinand6.6%withplacebo.Nosignificantdifferencewasfoundbetweentwogroups.GeometricmeanIgGtiterwasnosignifi2cantdifferenceaftertreatmenteitherinp
