本文選題：伊曲康唑 + 兩性霉素B�。� 參考：《浙江大學(xué)》2010年碩士論文

【摘要】： 目的：觀察和比較單純口服伊曲康唑與合用兩性霉素B滴眼液治療真菌性角膜炎的療效。 方法：研究對(duì)象為2006年10月至2008年9月在我院診治的病原培養(yǎng)陽(yáng)性的真菌性角膜炎病例。將病人根據(jù)病例號(hào)數(shù)字的奇偶性隨機(jī)分為A、B兩組,A組予以口服伊曲康唑膠囊(300mg／d),B組予以口服伊曲康唑聯(lián)合0.15％兩性霉素B滴眼液(每30min 1次)。如藥物治療1周病情加重,更改治療方案(加用藥物或介入手術(shù)),每周隨訪(fǎng)1次。根據(jù)疾病輕、中、重癥和不同致病菌分類(lèi),比較1周后兩組采用初始藥物方案治療后出現(xiàn)對(duì)藥物有效反應(yīng)的病例數(shù),以及采用初始藥物治療方案達(dá)到清除感染的病例數(shù)及治療時(shí)間。 結(jié)果：納入該研究的真菌性角膜炎病例共100例,A組48例,B組52例。A組中輕、中、重癥病例分別為13例(27％)、18例(38％)和17例(35％),B組為13例(25％)、17例(33％)和22例(42％),兩組的輕、中和重癥病例差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)初始藥物方案治療1周后,A、B兩組出現(xiàn)藥物有效反應(yīng)的病例分別為24例(50％)和38例(73％),差異有統(tǒng)計(jì)學(xué)意義(P=0.018)。采用初始治療方案達(dá)到清除感染的病例：A組25例(52％),B組40例(77％),其中,輕癥病例：兩組的初始藥物治愈率分別為92％和77％,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；中癥病例：兩組的初始藥物治愈率分別為50％和82％,差異有統(tǒng)計(jì)學(xué)意義(P=0.044)；重癥病例：兩組的初始藥物治愈率分別為24％和73％,差異有統(tǒng)計(jì)學(xué)意義(P=0.002)。采用初始治療方案治療達(dá)到清除感染的時(shí)間：A組中輕、中和重癥病例的平均治療時(shí)間分別為29天、50天和70天；B組中輕、中和重癥病例的平均治療時(shí)間分別為17天、30天和64天,其中輕、中癥病例的平均治療時(shí)間差異有統(tǒng)計(jì)學(xué)意義(輕度：P=0.026；中度：P=0.007)。 結(jié)論：對(duì)于輕癥真菌性角膜炎,采用單獨(dú)口服伊曲康唑或聯(lián)合使用兩性霉素B滴眼液,大部分病例可達(dá)到清除感染的目的。對(duì)于中或重癥病例,口服伊曲康唑聯(lián)合兩性霉素B滴眼液的療效優(yōu)于單獨(dú)口服伊曲康唑。
[Abstract]:Objective: to observe and compare the efficacy of oral itraconazole and amphotericin B eye drops in the treatment of fungal keratitis. Cases of bacterial keratitis. Patients were randomly divided into two groups according to the number of cases. Group A was given orally itraconazole capsule 300 mg / d and group B was given orally itraconazole combined with 0.15% amphotericin B eye drops (once per 30min). If the condition gets worse after 1 week of medication, change the treatment regimen (add medicine or interventional surgery, follow up once a week. According to the classification of mild, moderate, severe and different pathogenic bacteria, the number of patients in the two groups who appeared effective response to the drug after the initial drug regimen was compared one week later. Results: 100 cases of fungal keratitis were included in this study. There were 48 cases in group A and 52 cases in group B. There were 13 severe cases (18 cases) and 17 cases (group B, 13 cases) and 22 cases (42 cases). There was no significant difference in light, moderate and severe cases between the two groups (P 0.05). After one week of initial drug therapy, the effective drug response was found in 24 cases (50 cases) and 38 cases (73 cases) in the two groups respectively. The difference was statistically significant (P = 0.018). There were 25 cases in group A, 25 cases in group A, 40 cases in group B, and 77 cases in group B, among which, Mild cases: the initial drug cure rates of the two groups were 92% and 77% respectively, the difference was not statistically significant (P 0.05); the initial cure rate of the two groups was 50% and 82% respectively, the difference was statistically significant (P 0.044); severe cases: the initial cure rate of the two groups was 0. 044%. The cure rate of drug was 24% and 73% respectively, the difference was statistically significant. The average treatment time of initial treatment regimen was 29 days, 50 days and 70 days respectively, and the average treatment time was 17 days, 30 days and 64 days, respectively, in group A, and in group B, the average time of treatment was 29 days, 50 days and 70 days, respectively, and the average treatment time of group B was 17 days, 30 days and 64 days, respectively. There was significant difference in the average treatment time between mild and moderate cases (mild: P0.026; moderate: P0. 007. Conclusion: for mild fungal keratitis, itraconazole alone or amphotericin B eye drops were used alone. Most cases can achieve the goal of eliminating infection. For moderate or severe cases, the efficacy of oral itraconazole combined with amphotericin B eye drops was better than that of itraconazole alone.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R772.21

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 王麗婭!450003鄭州,張?jiān)虑?450003鄭州,王印其!450003鄭州,王剛生,盧嘉彪,鄧潔華;中國(guó)三地區(qū)真菌性角膜病致病菌種的調(diào)查[J];中華眼科雜志;2000年02期

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