伏立康唑治疗老年慢性阻塞性肺疾病合并侵袭性肺部真菌感染的疗效及安全性研究  

Study on the efficacy and safety of voriconazole in elderly patients with chronic obstructive pulmonary disease combined with invasive pulmonary fungal infection

作　　者：李秋梅 LI Qiu-mei(Department of Respiratory Medicine,People’s Hospital of Zhangqiu District,Jinan 250200,China)

机构地区：[1]山东省济南市章丘区人民医院呼吸内科,250200

出　　处：《中国实用医药》2021年第19期15-17,共3页China Practical Medicine

摘　　要：目的研究伏立康唑治疗老年慢性阻塞性肺疾病(COPD)合并侵袭性肺部真菌感染的疗效及安全性。方法72例老年COPD合并侵袭性肺部真菌感染患者,依照治疗方式不同分为对照组与观察组,各36例。对照组患者采用氟康唑治疗,观察组采用伏立康唑治疗。比较两组患者的治疗效果、治疗前后炎性因子水平及肝肾功能指标。结果观察组总有效率为97.22%(35/36),高于对照组的75.00%(27/36),差异具有统计学意义(P<0.05)。治疗前,两组白细胞介素(IL)-4、IL-10、IL-12和肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,观察组IL-4(3.47±1.03)ng/ml、IL-10(5.12±1.67)ng/ml高于对照组的(2.04±0.28)、(3.51±1.22)ng/ml,IL-12(6.68±1.59)ng/ml和TNF-α(1.45±0.54)ng/ml低于对照组的(12.59±4.97)、(2.77±0.76)ng/ml,差异具有统计学意义(P<0.05)。观察组尿素(BUN)、总胆红素(TBIL)、血清谷丙转氨酶(ALT)、谷草转氨酶(AST)和肌酐(Cr)水平与对照组比较,差异无统计学意义(P>0.05)。结论应用伏立康唑治疗老年COPD合并侵袭性肺部真菌感染疗效确切,可有效消除炎性因子,提高治疗效果,临床价值高。Objective To study the efficacy and safety of voriconazole in elderly patients with chronic obstructive pulmonary disease(COPD)combined with invasive pulmonary fungal infection.Methods A total of 72 elderly patients with COPD and invasive pulmonary fungal infection were divided into control group and observation group according to different treatment methods,with 36 cases in each group.The control group was treated with fluconazole,and the observation group was treated with voriconazole.The therapeutic effect,inflammatory factor and liver and kidney function indicators before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 97.22%(35/36),which was higher than 75.00%(27/36)of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in levels of interleukin(IL)-4,IL-10,IL-12 and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After treatment,the IL-4(3.47±1.03)ng/ml and IL-10(5.12±1.67)ng/ml of the observation group were higher than(2.04±0.28)and(3.51±1.22)ng/ml of the control group,and IL-12(6.68±1.59)ng/ml and TNF-α(1.45±0.54)ng/ml were lower than(12.59±4.97)and(2.77±0.76)ng/ml of the control group.All the difference was statistically significant(P<0.05).The levels of blood urea nitrogen(BUN),total bilirubin(TBIL),serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and creatinine(Cr)of the observation group had no statistically significant difference compared with those of the control group(P>0.05).Conclusion Voriconazole has affirmative efficacy in the treatment of elderly COPD patients with invasive pulmonary fungal infection,and it can effectively eliminate pneumonia factors and improve the therapeutic effect,which has high clinical value.

关 键 词：老年慢性阻塞性肺疾病 侵袭性肺部真菌感染 伏立康唑 氟康唑 

分 类 号：R519[医药卫生—内科学] R563.9[医药卫生—临床医学]