本文選題：伏立康唑 + 侵襲性肺真菌感染��； 參考：《中華醫(yī)院感染學雜志》2014年16期

【摘要】：目的分析伏立康唑治療肺侵襲性真菌感染的療效及安全性,指導(dǎo)臨床抗真菌感染的藥物選擇及治療時機。方法調(diào)查2012年7月-2013年8月血液內(nèi)科粒細胞缺乏發(fā)生肺部真菌感染住院患者共14例,所有患者均符合臨床診斷標準;先給予靜脈滴注伏立康唑治療,2周后改為口服維持,觀察患者體溫、肺部癥狀及體征、肺部CT影像學變化,總結(jié)伏立康唑治療肺部真菌感染的有效率,觀察伏立康唑治療過程中的不良反應(yīng)。結(jié)果 14例肺真菌感染患者中完全緩解9例占64.3%,部分緩解3例占21.4%,無效2例,中位起效時間4d;按CTC 3.0標準14例患者發(fā)生一級不良反應(yīng)共4例,發(fā)生率28.57%,其中谷丙轉(zhuǎn)氨酶及谷草轉(zhuǎn)氨酶升高,發(fā)生3例占21.4%,給予還原型谷胱甘肽治療后轉(zhuǎn)氨酶降至正常;全身皮膚皮疹1例占7.1%,給予口服馬來酸氯苯那敏后皮疹消退,期間伏立康唑均未給予減量或停藥。結(jié)論伏立康唑治療肺侵襲性真菌感染療效滿意,不良反應(yīng)發(fā)生率較低,且均在可控制范圍。
[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.
【作者單位】： 東營市人民醫(yī)院血液內(nèi)科;中國醫(yī)學科學院天津血液病研究所;
【基金】：國家自然科學基金資助項目(81370611)
【分類號】：R519

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