伏立康唑治疗重症患者侵袭性真菌感染的回顾性分析

发布时间：2019-04-28 18:11

【摘要】：目的:评价某"三甲"医院伏立康唑在重症患者侵袭性真菌感染(IFI)中使用的有效性、安全性。方法:回顾性调查该"三甲"医院2012年7月-2013年6月住院重症患者使用伏立康唑的情况,以患者基本信息、感染类型、细菌培养结果、给药方案及使用时间、合并用药等作为考察指标进行相关分析。结果:使用伏立康唑的173例患者中,123例(71.1%)有效,22例患者存在不同程度肝功能不全,其中14例治疗有效;60.1%的患者(104/173)在用药前有相关微生物学检查结果,其中63.5%的患者(66/104)为曲霉菌半乳甘露聚糖抗原检测(GM试验)阳性,27.9%的患者(29/104)为真菌培养阳性,微生物检查结果阳性组治疗有效率为80.8%,阴性组有效率为56.5%,两组比较差异有统计学意义(P0.05);有3例发生不良反应,其中1例为联用环孢素后因血药浓度升高而导致调整给药方案。结论:伏立康唑能安全、有效地治疗重症患者的侵袭性真菌感染,但仍应密切关注患者肝肾功能、药物间相互作用及血常规的监测,以减少不良反应的发生,减缓耐药性的产生,减轻患者经济负担。
[Abstract]:Aim: to evaluate the efficacy and safety of Voliconazole in patients with invasive fungal infection (IFI). Methods: from July 2012 to June 2013, the use of Voliconazole was investigated retrospectively. The basic information of the patients, the type of infection, the results of bacterial culture, the drug administration scheme and the time of use were analyzed. Combined use of drugs as indicators for correlation analysis. Results: of 173 patients treated with Voliconazole, 123 (71.1%) were effective, 22 patients had liver dysfunction in varying degrees, and 14 of them were effective. 60.1% of the patients (104 / 173) had the results of microbiological examination before treatment, among which 63.5% (66 / 104) were positive for aspergillus galactomannan antigen (GM test), and 63.5% (66 / 104) were positive for Aspergillus galactomannan antigen. 27.9% (29 / 104) of the patients were fungal culture positive. The effective rate was 80.8% in the positive group and 56.5% in the negative group. There was a significant difference between the two groups (P0.05). Adverse reactions occurred in 3 cases, one of them was caused by the increase of blood concentration of cyclosporine, which resulted in the adjustment of drug administration regimen. Conclusion: Voliconazole is safe and effective in the treatment of invasive fungal infection in severe patients, but we should pay close attention to the liver and kidney function, drug interaction and blood routine monitoring in order to reduce the occurrence of adverse reactions. Slow down the emergence of drug resistance, reduce the economic burden of patients.
【作者单位】：西安交通大学医学院第一附属医院;西安医学院;
【基金】：国家自然科学基金资助项目(No.81201490)
【分类号】：R519

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