伏立康唑经验治疗侵袭性肺曲霉病的临床疗效研究  

Vorieonazole for invasive pulmonary aspergillosis

作　　者：李燕燕[1] 王雯[1] 信淑珍[1] 

机构地区：[1]滨州市人民医院呼吸科,256603

出　　处：《国际医药卫生导报》2014年第20期3134-3138,共5页International Medicine and Health Guidance News

摘　　要：目的观察伏立康唑经验治疗侵袭性肺曲霉病（IPA）的临床疗效以进一步指导临床用药。方法采用病例对照研究，收集我院2010年1月到2012年10月使用伏立康唑治疗侵袭性肺曲霉病住院患者65例。65例患者分为两组：经验治疗组35例，即入院后痰培养前拟诊为IPA感染（该组即为临床拟诊组）后，立即应用伏立康唑首日每次6mg／kg，每12h一次，以后每次4mg／kg，每日给药2次，均为静脉滴注治疗，治疗过程中均证实为曲霉感染；目标治疗组30例，确诊为曲霉感染（该组即包括临床诊断组和确诊组）后再选用伏立康唑治疗，剂量与用法与经验治疗组相同。结果经验治疗组与目标治疗组有效率分别为51．43％、23．33％（P=0．020），病死率分别为22．86％、46．67％（P=0．040），差异均具有统计学意义；不良反应发生率分别为20．00％、16．67％（P=0．73），差异无统计学意义；对于高危人群，经验治疗组有效率为53．13％，目标治疗组有效率为22．22％，两组比较，有明显差异（P=0．015）。结论伏立康唑作为IPA的经验用药，能提高临床疗效，降低病死率，尤其是针对真菌感染高危人群，能明显提高有效率。Objective To observe the clinical efficacy of voriconazole in the empirical treatment of invasive pulmonary aspergillosis and to guide the clinical medication. Methods 65 inpatients with invasive pulmonary aspergillosis receiving voriconazole treatment in our hospital from January 2010 to October 2012 were collected and then were divided into an empirical treatment group （35 cases） and a target treatment group （30 cases）. The empirical treatment group were suspected with invasive pulmonary aspergillosis before sputum culture results and were immediately treated with voriconazole（Jineheng Pharmaceutical Hayes） 6 mg/kg once every 12h on day 1 then 4 mg/kg twice daily. The target treatment group were treated with voriconazole in the same way after being confirmed with invasive pulmonary aspergillosis. Results The effective rate and the mortality rate were 51.43% and 23.33% in the empirical treatment group and were 22.86% and 46.67% in the target treatment group, with statistical differences （ P=0.020,P=0.040 ） . The adverse effect rate was 20.00% in the empirical treatment group and was 16.67% in the target treatment group, with no statistical difference （P=0.73） . The effective rate was 53.13% in the empirical treatment group and was 22.22% in the target treatment group, with a statistical difference （P=0.015） .Conclusions Voriconazole can be used as empirical treatment for invasive pulmonary aspergillosis, which can improve the effective rate in clinical treatment and reduce mortality. Especially for patients with high risk factors, voriconazole can significantly improve the effective rate.

关 键 词：伏立康唑 侵袭性肺曲霉病 经验治疗 

分 类 号：R519[医药卫生—内科学]