卡泊芬净与克林霉素联合治疗非HIV感染者重症肺孢子菌肺炎的疗效及安全性分析  

Analysis of the efficacy and safety of combined treatment of caspofungin and clindamycin in non-HIV-infected patients with severe pneumocystis pneumonia

作　　者：韩飞[1] 韩会建 宋亚茹[1] HAN Feil;HAN Huijian;SONG Yaru(Department of Respiratory and Critical Care Medicine,First People's Hospital of Xinxiang City,Xinxiang 453000,China;Medical School,Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]新乡市第一人民医院呼吸与危重症医学科,河南新乡453000 [2]郑州大学医学院脑瘫外科研究治疗中心,郑州450052

出　　处：《河南大学学报（医学版）》2021年第1期38-40,48,共4页Journal of Henan University:Medical Science

摘　　要：[目的]探讨卡泊芬净联合克林霉素治疗非人类免疫缺陷病毒(HIV)感染重症肺孢子菌肺炎(PCP)患者的疗效及安全性。[方法]选择2017年4月至2020年5月某医院非HIV感染重危PCP患者82例,以随机数字表法分为A组(n=41)、B组(n=41)。B组予以卡泊芬净,A组予以卡泊芬净结合克林霉素,均治疗2周。比较2组疗效、症状改善时间、不良反应与治疗前、治疗2周后血清白细胞介素-23(IL-23)、白细胞介素-8(IL-8)、干扰素-γ(IFN-γ)、白细胞介素-10(IL-10)水平。[结果]A组治疗2周后总有效率为92.68%,高于B组的73.17%(P<0.05);经治疗,A组呼吸困难消失、退热、咳嗽消失时间短于B组(P<0.05);A组治疗2周后血清IL-23、IL-8、IFN-γ、IL-10水平低于B组(P<0.05);治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。[结论]非HIV感染重症PCP患者经卡泊芬净与克林霉素联合治疗可显著减轻机体炎症反应,改善临床症状,提升疗效,且安全性好。[Objective]To investigate the efficacy and safety of caspofungin combined with clindamycin in the treatment of patients with severe pneumocystis pneumonia(PCP)infected by non-human immunodeficiency virus(HIV).[Methods]From April 2017 to May 2020,82 patients with non-HIV infected PCP in one hospital were selected and divided into group A(n=41)and group B(n=41)by random number table.Group B received caspofungin,group A received caspofungin combined with clindamycin,both were treated for 2 weeks.The curative effect,time of symptom improvement,adverse reactions and serum interleukin-23(IL-23),interleukin-8(IL-8),interferon-γ(IFN-γ),interleukin-10(IL-10)levels before and 2 weeks after treatment were compared between the two groups.[Results]The total effective rate in group A was 92.68%after 2 weeks of treatment,which was higher than 73.17%in group B(P<0.05).After treatment,the disappearance of dyspnea,fever and cough in group A was shorter than that in group B(P<0.05).Serum levels of IL-23,IL-8,IFN-γand IL-10 in group A were lower than those in group B after 2 weeks of treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P>0.05).[Conclusion]The combination of caspofungin and clindamycin in non-HIV-infected patients with severe PCP can significantly reduce the body’s inflammatory response,improve clinical symptoms,improve efficacy,and have good safety.

关 键 词：人类免疫缺陷病毒 重症肺孢子菌肺炎 克林霉素 卡泊芬净 

分 类 号：R563.9[医药卫生—呼吸系统]