卡泊芬净治疗严重烧伤患者真菌感染的临床疗效分析  

Clinical efficacy of Caspofungin in treatment of fungal infections in severe burn patients

作　　者：祖红旭[1] 黄培信[1] 李庆华[1] 

机构地区：[1]河南科技大学第一附属医院烧伤科,河南洛阳471003

出　　处：《中华医院感染学杂志》2014年第2期355-357,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关计划基金项目(132102310472)

摘　　要：目的探讨卡泊芬净治疗严重烧伤发生真菌感染患者的临床效果,以提高痊愈率。方法收集医院2005年4月-2012年12月收治的31例严重烧伤并发真菌感染患者临床资料,将采用卡泊芬净治疗的17例患者设为观察组,采用伊曲康唑治疗的14例患者设为对照组,对比分析两组的疗效及药物安全性。结果真菌感染的主要临床表现为发热、肺部啰音、咳嗽咳痰、胸片示肺部阴影、意识模糊等;共分离出真菌31株,以白色假丝酵母菌、热带假丝酵母菌、隐球酵母菌属为主,分别占64.52%、19.35%、9.68%;感染部位以创面、呼吸道感染为主,分别占48.39%、19.36%;观察组治疗总有效率为88.2%,对照组治疗总有效率为71.4%,两组比较差异无统计学意义;观察组未出现与用药相关的不良反应病例,对照组中出现3例不良反应病例,其不良反应率为21.43%,两组比较差异有统计学意义(P<0.05)。结论对严重烧伤并发真菌感染的患者采用卡泊芬净作为首选治疗药物,疗效确切且不良反应小、安全可靠,值得在临床推广。OBJECTIVE To evaluate the clinical efficacy of easpofungin in treatment of fungal infections in the severe burn patients so as to improve the cure rate. METHODS The clinical data of 31 cases of severe burn patients com- plicated with fungal infections who were treated in the hospital from Apt 2005 to Dec 2012 were collected, then 17 subjects who were treated with caspofungin were set as the observation group, while 14 subjects who were treated with itraeonazole were set as the control group; the clinical efficacy and the drug safety were observed and com- pared between the two groups. RESULTS The major clinical manifestations of the subjects with fungal infections included the fever, pulmonary rales, cough and expectoration, chest X-ray showing lung shadow, and confusion. Totally 31 strains of fungi have been isolated, among which the Candida albicans accounted for 64.52%, Candida tropicalis 19.35 %, Cryptococcus 9.68 %. The patients with wound infections accounted for 48.39 %; the patients with respiratory tract infections accounted for 19.36%. The total effective rate of treatment was 88.2% in the ob- servation group, 71.4% in the control group, the difference between the two groups was not statistically signifi- cant. There was no case of drug use-associated adverse reactions in the observation group and 3 （21.43 %） cases in the control group, the difference in the incidence of adverse reactions between the two groups was statistically sig- nificant（P〈0.05）. CONCLUSION Caspofungin can be used as the preferred drug for the treatment of fungal infec- tions in the severe burn patients, with the clinical efficacy accurate, incidence of adverse reactions low, and it is worthy to be promoted in the hospital.

关 键 词：卡泊芬净 烧伤 真菌 感染 

分 类 号：R978.1[医药卫生—药品]