卡泊芬净治疗重症侵袭性肺部真菌感染的疗效及安全性评价  

Evaluation of Therapeutic Efficacy and Safety of Caspofungin in the Treatment of Severe Invasive Pulmonary Fungal Infection

作　　者：骆雪萍[1] 施善阳[1] 叶宁[1] 夏炳杰[1] 

机构地区：[1]桂林医学院附属医院ICU,桂林市541001

出　　处：《中国药房》2011年第26期2464-2466,共3页China Pharmacy

基　　金：广西卫生厅项目(Z2010298)

摘　　要：目的:了解卡泊芬净治疗重症侵袭性肺部真菌感染(IPFI)的疗效及安全性。方法:回顾性分析2008年4月-2010年9月ICU使用卡泊芬净5d以上的18例重症IPFI患者的临床资料。卡泊芬净首剂70mg,后据肝功能分级予50mg.d-1或35mg·d-1。治疗期间监测肺部影像学、肝肾功能等。结果:临床诊断14例、拟诊4例。治疗总有效率72.22%(13/18)。有效组疗程长于无效组((21.55±6.91)dvs.(10.00±3.50)d,P<0.05),抢先/经验性治疗组有效率高于目标/挽救治疗组(91.67%vs.33.33%,P<0.05)。有效组肺部影像改善时间明显滞后。未见明显不良反应。结论:卡泊芬净是治疗重症IPFI安全、有效的药物选择,且抢先治疗能提高疗效。OBJECTIVE：To investigate therapeutic efficacy and safety of caspofungin in the treatment of severe invasive pulmonary fungal infection （IPFI）. METHODS： The clinical data of 18 cases of severe IPFI treated by caspofungin （the duration was up to 5 days） between Apr. 2008 and Sept. 2010 were retrospectively analyzed. The patients were treated with caspofungin in a dose of 70 mg at the first day, and then 50 mg·d-1 or 35 mg·d-1 according to liver function classification Child-Pugh score. Lung’s image, liver and kidney function were monitored during treatment. RESULTS： There were 14 probable cases and 4 possible cases. The overall effective rate was 72.22%（13/18）. The treatment duration of effective group was longer than that of ineffective group （21.55±6.91）d vs.（10.00±3.50）d,P〈0.05）. The effective rate of preemptive/empirical therapy group was higher than that of goal/rescue therapy group（91.67% vs. 33.33%,P〈0.05）. It is delayed obviously to improve lung’s image in effective group. No significant adverse drug reaction was found during treatment. CONCLUSION： Caspofungin is effective drug for critical patients with severe IPFI. Preemptive therapy may improve therapeutic efficacy.

关 键 词：卡泊芬净 重症患者 侵袭性肺部真菌感染 

分 类 号：R969.4[医药卫生—药理学] R519[医药卫生—药学]