目的探讨慢性肾衰竭患者头孢菌素脑病的发病机制、临床特点、治疗方法及转归。方法回顾性分析使用头孢菌素类药物后出现脑病的28例慢性肾衰竭患者,分析与头孢菌素脑病发生的相关因素。结果 28例慢性肾衰竭患者引起头孢菌素脑病发生的抗菌药物包括:头孢硫咪、头孢吡肟、头孢哌酮/舒巴坦、头孢他啶和头孢替安,所有患者均无神经定位体征,CT扫描检查无病理性改变,慢性肾衰竭患者发生头孢菌素脑病较未发生头孢菌素脑病患者的年龄明显增加,接受透析的患者头孢菌素脑病发生率明显低于未透析者,头孢菌素脑病的发生与抗菌药物的剂量有明显关系,停用头孢类药物或减量后症状消失。结论头孢菌素脑病的发病机制考虑与慢性肾衰竭致排泄率降低有关,且增龄是其危险因素,透析可减少其发生,如能及早发现,及早进行对症治疗,绝大多数患者预后良好。

Objective To explore the pathogenesis,clinical characteristics,treatment and prognosis of cephalosporin encephalopathy in patients with chronic renal failure (CRF).Methods The neuropsychiatric symptoms and treatment strategies of cephalosporin encepha-lopathy in 28 patients with CRF who were treated with cephalosporin drugs during January 2008 and June 2013 were retrospectively analyzed, and the influential factors of cephalosporin encephalopathy were analyzed as well.Results All the patients had no neurological signs and po-sitioning.CT showed no pathological changes,among CRF,those with cephalosporin encephalopathy were older than those without,incidence of cephalosporin encephalopathy in which did not receive dialysis was significantly higher than those already had,and the symptoms disap-peared after withdrawal.Conventional dose of these antibiotics was correlated with the occurrent of cephalosporin encephalopathy.Conclusion The pathogenesis of encephalosporin encephalopathy in pati

目的：了解北京市中关村医院（以下简称“我院”）呼吸科头孢菌素类抗菌药物的使用情况。方法：采用世界卫生组织推荐的用药频度（ DDDs）分析法，通过医院信息系统，统计2011—2013年我院呼吸科使用的头孢菌素类抗菌药物的药品名称、规格、数量等，计算出DDDs和销售金额并对其进行排序、分析。结果：近3年来，我院呼吸科使用的头孢菌素类抗菌药物的DDDs和销售金额均呈上升趋势；第3代头孢菌素使用的种类最多，且其DDDs和销售金额排序也居首位；第4代头孢菌素的DDDs和销售金额明显低于第3代和第2代头孢菌素。结论：我院呼吸科使用头孢菌素类抗菌药物较合理，但应严格控制第3代头孢菌素的用药指征，以提高疗效、延缓细菌耐药性的产生。

OBJECTIVE:To investigate the use of cephalosporin antibiotics in patients from the respiratory department of Beijing Zhongguancun Hospital ( hereinafter referred to as “our hospital”) .METHODS: The data including drug names , specifications , quantities etc of cephalosporin antibiotics used in patients from the respiratory department of our hospital from 2011 to 2013 were retrieved from hospital information system for analysis of DDDs and consumption sum and their order using DDDs analysis as recommended by WHO . RESULTS: Both DDDs and consumption sum of cephalosporins showed increasing tendency from 2011 to 2013 . The third-generation cephalosporins were predominantly used and it took the lead in both DDDs and consumption sum .The DDDs and consumption sum of the fourth-generation cephalosporin antibiotics were significantly lower than those of the third -generation or second-generation cephalosporin antibiotics .CONCLUSIONS: The use of cephalosporin antibiotics in patients

目的：了解不同生产企业的第一、二代头孢菌素对金黄色葡萄球菌、大肠埃希菌的体外抗菌活性，为临床选用抗菌药物提供依据。方法选取临床常用的第一、二代头孢菌素制成药敏纸片，采用K－B纸片扩散法进行药敏试验，按 NCCLS（2002版）标准判读结果。结果不同生产企业的头孢唑啉与头孢唑啉标准药敏纸片对金黄色葡萄球菌、大肠埃希菌的敏感率无显著性差异（ P＜0．05）；头孢硫脒对金黄色葡萄球菌的敏感率与头孢唑啉无显著性差异（ P＜0．05） ，对大肠埃希菌的敏感率与头孢唑啉有显著性差异（ P＜0．05）；头孢呋辛及头孢替安对金黄色葡萄球菌、大肠埃希菌的敏感率与头孢呋辛标准药敏纸片无显著性差异（P＜0．05）。结论不同生产企业的头孢唑啉对金黄色葡萄球菌、大肠埃希菌的体外抗菌活性相当；头孢硫脒对金黄色葡萄球菌的体外抗菌活性与头孢唑啉相当，对大肠埃希菌无抗菌活性；头孢呋辛及头孢替安对金黄色葡萄球菌、大肠埃希菌的体外抗菌活性相当。

ABSTRACT:OBJECTIVE To Investigate antibacterial activity of the first and second generation cephalosporins of different manufacturers against Staphylococcus aureus and Escherichia coli in vitro.METHODS Selected the first and second generation cephalosporins to made susceptibility paper ,tested by Kirby-Bauer method,Determinated ac-cording to NCCLS (2008 edition).RESULTS The drug susceptibility rates of Cefazolin of different manufacturers was consistent against Staphylococcus aureus and Escherichia coli in vitro;The drug sensitivity rate of Cefathiamidine was consistent with Cefazolin ’s against Staphylococcus aureus in vitro ,however,it was different against Escherichia coli (P<0.05).The drug susceptibility rates of Cefuroxime was consistent with Cefotiam against Staphylococcus au -reus and Escherichia coli in vitro.CONCLUSION The antibacterial activity of Cefazolin of different manufacturers is similar against Staphylococcus aureus and Escherichia coli in vitro.The antibac

目的通过对第三代头孢菌素类抗生素的不良反应分析,为提高临床合理安全使用抗生素提供参考。方法采用回顾性调查方法,利用Excel对收集的不良反应报告进行统计,对不良反应的药品、给药途径、临床表现等数据分类统计和分析。结果第三代头孢菌素类抗生素不良反应涉及药品11种,涉及最多不良反应的是头孢曲松和头孢哌酮。药品不良反应累及7个器官或系统,比例最高的是变态反应。结论应关注头孢菌素类抗生素不良反应,提高合理用药水平。

Objective Through the analysis of adverse reactions to the third generation cephalosporin antibiotics, so as to provide reference for clinical rational use of antibiotics. Methods Using the method of retrospective investigation, and using Excellto collect adverse reaction reports and take statistics, to statistics and analysis the data of adverse reaction of drugs, routes of administration, clinical performance. Results The adverse reactions of the third generation of cephalosporin drugs related to 11 , involving the most adverse reaction of cefoperazone was rocephin and cefoperazone. Adverse drug reaction involved 7 organs or systems, and the highest proportion is allergic reaction. Conclusion We should pay attention to adverse reactions of cephalosporins to improve the level of rational use of drugs.

目的系统评价基于头孢菌素类或青霉素类幽门螺杆菌根除方案的有效性及安全性。方法计算机检索Pubmed、Embase等数据库,收集相关随机对照试验,终点指标为幽门螺杆菌根除率、不良反应发生率以及溃疡愈合率。共纳入5项研究,513名患者。结果基于头孢菌素类或青霉素类根除方案的有效性,两者差别无统计学意义(P0.05)。药物不良反应发生率,头孢菌素组显著低于青霉素组(P0.01);无严重不良反应发生。结论 2种方案有效性相似,但头孢菌素类较青霉素类不良反应发生率更低。

Objective To compare the relative efficacy and safety of cephalosporins or penicillins based H.pylori eradication regimen.Meth-ods Electronic databases were searched to identify the randomized con-trolled trials ( RCTs ) comparing cephalosporins and penecillins for H.pylori eradication.The outcome measure was H.pylori eradication rate , incidence of adverse drug reactions ( ADR) and ulcer healing.Five stud-ies including 513 patients were identified.Results No statistical differ-ence on H.pylori eradication efficacy between cephalosporins and peni-cillins based regimen was shown on Meta -analysis ( P>0.05 ).No se-vere adverse drug reaction ( ADR) was reported in the identified studies , but the incidence of ADR of cephalosporins group was significantly lower than that of penicillin group ( P<0.01 ).Conclusion The efficacy of cephalosporins is similar to penicillins for H.pylori eradication , but cephalosporins have shown a significantly lower incidence of ADR.