伏立康唑片联合卡泊芬净注射剂治疗血液病合并侵袭性肺部曲霉菌属感染的临床研究

发布时间：2018-05-03 18:55

本文选题：伏立康唑片 + 卡泊芬净注射剂　；参考：《中国临床药理学杂志》2017年19期

【摘要】：目的观察伏立康唑片联合卡泊芬净注射剂治疗血液病合并侵袭性肺部曲霉菌属感染的临床疗效及安全性。方法将100例血液病合并侵袭性肺部曲霉菌属感染患者随机分为对照组50例和试验组50例。对照组予以两性霉素B首剂5 mg,以后每天增加5 mg,最大剂量25 mg,再以25 mg·d~(-1)的剂量应用10 d,qd,静脉滴注;试验组予以醋酸卡泊芬净首剂70 mg,以后调整为50 mg,qd,静脉滴注+伏立康唑,第1天6 mg·kg~(-1),第2天调整为4 mg·kg~(-1),bid,口服。对照组治疗15 d,试验组治疗15~28 d(治疗至完全起效)。比较2组患者的临床疗效和药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为88.00%(44/50例)和68.00%(34/50例),经验性治疗总有效率分别为92.31%(24/26例)和81.48%(22/27例),抢先性治疗总有效率分别为83.33%(20/24例)和52.17%(12/23例),差异均有统计学意义(均P0.05)。试验组发生的药物不良反应以神经系统损伤和肝肾功能障碍为主,对照组发生的药物不良反应神经系统损伤、外周性水肿、肝肾功能障碍、视觉异常为主。试验组和对照组的药物不良反应发生率分别为4.00%和14.00%,差异有统计学意义(P0.05)。结论伏立康唑片联合卡泊芬净注射剂治疗血液病合并侵袭性肺部曲霉菌属感染的临床疗效显著,且安全性较高。
[Abstract]:Objective to observe the clinical efficacy and safety of Volconazole tablets combined with carpofen injection in the treatment of hematological diseases with invasive pulmonary aspergillus infection. Methods 100 patients with hematologic diseases complicated with invasive pulmonary aspergillosis were randomly divided into control group (n = 50) and experimental group (n = 50). The control group was given amphotericin B first dose of 5 mg, then increased 5 mg / day, the maximum dose was 25 mg / day, then 10 d / d QD was given to the control group, and the experimental group was given 70 mg / g carpofen acetate, then adjusted to 50 mg / g QD, and was injected with Veconazole intravenously, and the control group was given amphotericin B first dose (70 mg / d). On the first day, the dosage of 6 mg / kg was 6 mg / kg ~ (-1) and on the second day it was adjusted to 4 mg / kg ~ (-1) tibia. The control group was treated for 15 days and the experimental group for 15 to 28 days. The clinical efficacy and adverse drug reactions were compared between the two groups. Results after treatment, The total effective rates of the trial group and the control group were 88.00 / 44 / 50 and 68.00 / 34 / 50, respectively. The total effective rates of empirical therapy were 92.31 / 24 / 26 and 81.48 / 22 / 27, respectively. The total effective rates of preemptive treatment were 83.3320 / 24 and 52.1712 / 23, respectively. The main adverse drug reactions in the test group were nervous system injury and liver and kidney dysfunction, while in the control group, there were nervous system injury, peripheral edema, liver and kidney dysfunction and visual abnormality. The incidence of adverse drug reactions in the test group and the control group was 4.00% and 14.00%, respectively. The difference was statistically significant (P 0.05). Conclusion Volconazole tablets combined with Carpofen injection are effective and safe in the treatment of hematologic diseases with invasive pulmonary aspergillus infection.
【作者单位】：浙江医院呼吸内科;
【分类号】：R519;R55

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