6例泊沙康唑口服混悬液治疗肺毛霉病的临床特征及疗效分析  

Clinical characteristics and therapeutic effect of 6 cases of pulmonary mucormycosis treated with posaconazole oral suspension

作　　者：关克磊[1] 王彦芳[1] 申珅[2] 陈哲 杨勇杰 丁艳霞[3] GUAN Ke-lei;WANG Yan-fang;SHEN Shen;CHEN Zhe;YANG Yong-jie;DING Yan-xia(Department of pharmacy,The First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450052,China;Department of infectious disease,The First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450052,China;Department of rheumatology and immunology,The First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院药学部,河南郑州450052 [2]郑州大学第一附属医院感染科,河南郑州450052 [3]郑州大学第一附属医院风湿免疫科,河南郑州450052

出　　处：《中国医院药学杂志》2022年第6期647-650,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:总结肺毛霉病的临床特征及泊沙康唑口服混悬液治疗肺毛霉病的疗效。方法:回顾性分析2019年1月至2021年1月期间在郑州大学第一附属医院确诊为肺毛霉病并使用泊沙康唑口服混悬液住院治疗的6例患者的临床资料。结果:6例患者中,男性2例,女性4例,平均年龄(51.83±11.57)岁。6例患者中2例合并2型糖尿病,2例近1月内有手术史,1例合并慢性支气管炎,2例合并恶性血液系统疾病,1例无基础疾病。患者常见临床表现为发热、咳嗽、咳痰等,自发病至确诊平均时间为(19.33±12.18)d。6例患者平均中性粒细胞绝对值(10.57±9.48)×10^(9)/L。肺部CT影像学特征表现为积液、空洞、结节、团块影、“反晕轮”征等。6例患者中仅1例进行了血药浓度监测。6例患者中3例使用两性霉素B和泊沙康唑口服混悬液联合治疗,后序贯为泊沙康唑口服混悬液单药治疗,其中2例康复,1例因大咳血死亡;其余3例单用泊沙康唑口服混悬液治疗,其中2例痊愈,1例死于严重并发症。结论:肺毛霉病死亡率高,早期诊断至关重要,合并恶性肿瘤、糖尿病、长期应用激素及免疫抑制剂的患者需警惕肺毛霉病。泊沙康唑口服混悬液治疗肺毛霉病有一定疗效,临床治疗过程中需要合理开展泊沙康唑血药浓度监测。OBJECTIVE To summarize the clinical characteristics of pulmonary mucormycosis and the efficacy of posaconazole oral suspension in the treatment of pulmonary mucormycosis.METHODS The clinical data of 6 patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 who were diagnosed with pulmonary mucormycosis and treated with posaconazole oral suspension were analyzedretrospectively.RESULTS Among the 6 patients with pulmonary mucormycosis,there were 2 males and 4 females,the mean age was(51.83±11.57)years old.Among the 6 patients,2 patients were complicated with type 2 diabetes mellitus,2 patients were complicated with surgical prognosis,1 case was complicated with chronic bronchitis,2 cases were complicated with hematologic malignancies,and 1 case had no underlying diseases.The common clinical manifestations of the patients were cough,sputum,fever,etc.The average time from onset to diagnosis was(19.33±12.18)days.Among 6 patients,the mean absolute value of neutrophils was(10.57±9.48)×10^(9)/L.The imaging features of pulmonary CT showed effusion,cavity,nodule,mass shadow,“anti-halo”sign,etc.Blood concentration monitoring was performed in 1 of the 6 patients.Among the 6 patients,3 patients were treated with amphotericin B combined with posaconazole oral suspension,followed by posaconazole oral suspension alone.Among them,2 patients recovered and 1 patient died due to massive hemoptysis.The remaining 3 cases were treated with posaconazole oral suspension alone,of which 2 were cured and 1 died of severe complications.CONCLUSION The mortality rate of pulmonary mucormycosis was high,early diagnosis was very important,posaconazole oral suspension had certain curative effect in the treatment of pulmonary mucormycosis.Posaconazole blood concentration monitoring should be carried out reasonably during clinical treatment.

关 键 词：泊沙康唑口服混悬液 肺毛霉病 临床特征 疗效 

分 类 号：R453.2[医药卫生—治疗学]