伏立康唑治疗粒细胞缺乏患者肺侵袭性真菌感染疗效分析

发布时间：2018-04-11 12:42

本文选题：伏立康唑 + 侵袭性肺真菌感染　；参考：《中华医院感染学杂志》2014年16期

【摘要】：目的分析伏立康唑治疗肺侵袭性真菌感染的疗效及安全性,指导临床抗真菌感染的药物选择及治疗时机。方法调查2012年7月-2013年8月血液内科粒细胞缺乏发生肺部真菌感染住院患者共14例,所有患者均符合临床诊断标准;先给予静脉滴注伏立康唑治疗,2周后改为口服维持,观察患者体温、肺部症状及体征、肺部CT影像学变化,总结伏立康唑治疗肺部真菌感染的有效率,观察伏立康唑治疗过程中的不良反应。结果 14例肺真菌感染患者中完全缓解9例占64.3%,部分缓解3例占21.4%,无效2例,中位起效时间4d;按CTC 3.0标准14例患者发生一级不良反应共4例,发生率28.57%,其中谷丙转氨酶及谷草转氨酶升高,发生3例占21.4%,给予还原型谷胱甘肽治疗后转氨酶降至正常;全身皮肤皮疹1例占7.1%,给予口服马来酸氯苯那敏后皮疹消退,期间伏立康唑均未给予减量或停药。结论伏立康唑治疗肺侵袭性真菌感染疗效满意,不良反应发生率较低,且均在可控制范围。
[Abstract]:Objective to analyze the efficacy and safety of Volconazole in the treatment of pulmonary invasive fungal infection, and to guide the choice of antifungal drugs and the time of treatment.Methods from July 2012 to August 2013, 14 patients with pulmonary fungal infection due to hematologic granulocytosis were investigated, all of whom met the clinical diagnostic criteria.The body temperature, pulmonary symptoms and signs, CT imaging changes of lung were observed, the effective rate of treatment of pulmonary fungal infection was summarized, and the adverse reactions during the treatment of voriconazole were observed.Results among the 14 patients with pulmonary fungal infection, 9 cases had complete remission (64.3%), 3 cases had partial remission (21.4%), 2 cases had no effect, and the median onset time was 4 days.The incidence rate was 28.57, in which alanine aminotransferase and alanine aminotransferase were increased in 3 cases (21.4%), aminotransferase decreased to normal after treatment with reduced glutathione, skin rash in 1 case (7.1%) disappeared after oral administration of chlorphenamine maleate.During the period of Volconazole, no reduction or withdrawal of the drug.Conclusion the efficacy of Volconazole in the treatment of pulmonary invasive fungal infection is satisfactory, and the incidence of adverse reactions is low and within the range of control.
【作者单位】：东营市人民医院血液内科;中国医学科学院天津血液病研究所;
【基金】：国家自然科学基金资助项目(81370611)
【分类号】：R519

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