伏立康唑不同途径给药抗肺结核并发肺曲霉菌病的效果分析  

Effect Analysis of Voriconazole Administration on Pulmonary Tuberculosis Complicated with Pulmonary Aspergillus Disease by Different Routes

作　　者：闫莎莎[1] YAN Sha-sha(Department of Pleurisy,the Sixth People's Hospital of Zhengzhou,Henan Province,Zhengzhou 450015)

机构地区：[1]河南省郑州市第六人民医院胸膜炎科,郑州450015

出　　处：《实用中西医结合临床》2022年第18期5-8,15,共5页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探究伏立康唑不同给药方式对肺结核(TB)并发肺曲霉菌病(PA)患者临床疗效的影响。方法:选取2019年7月至2022年2月收治的126例TB并发PA患者,采用随机法进行分组。两组均给予对症治疗,常规组于对症治疗基础上给予伏立康唑口服治疗,研究组于对症治疗基础上给予伏立康唑序贯疗法。对比两组临床疗效、治疗前后炎症介质[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、C反应蛋白(CRP)]、红细胞沉降率(ESR)、免疫功能[免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)]、肺功能[肺动态顺应性(Cdyn)、响应频率(Fres)、气道阻力(RAW)、气道峰压(PIP)]及不良反应发生情况。结果:研究组治疗总有效率(92.06%)高于常规组(76.19%)(P<0.05);治疗后,研究组TNF-α、IL-8、CRP、ESR水平低于常规组(P<0.05);治疗后,研究组Ig A、Ig M、Ig G水平高于常规组(P<0.05);治疗后,研究组Cdyn高于常规组,Fres、RAW、PIP低于常规组(P<0.05);研究组不良反应发生率(11.11%)与常规组(19.05%)比较无显著差异(P>0.05)。结论:伏立康唑序贯疗法能提高TB并发PA患者临床疗效,有效抑制炎症反应,改善患者免疫功能及肺功能,且安全性较高。Objective:To investigate the effect of different administration methods of voriconazole on the clinical efficacy of patients with pulmonary tuberculosis(TB)complicated with pulmonary aspergillosis(PA).Methods:126patients with TB complicated with PA admitted from July 2019 to February 2022 were selected and grouped using a randomization method.Both groups were given symptomatic treatment,the conventional group was given oral voriconazole on the basis of symptomatic treatment,and the study group was given sequential voriconazole on the basis of symptomatic treatment.The clinical efficacy,inflammatory mediators[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),C-reactive protein(CRP)],erythrocyte sedimentation rate(ESR)],immune function[immunoglobulin A(Ig A),Ig M,Ig G],lung function[pulmonary dynamic compliance(Cdyn),response frequency(Fres),airway resistance(RAW),peak airway pressure(PIP)]and the occurrence of adverse reactions.Results:The total effective rate of treatment in the study group(92.06%)was higher than in the conventional group(76.19%)(P<0.05);the levels of TNF-α,IL-8,CRP and ESR in the study group were lower than in the conventional group after treatment(P<0.05).The levels of Ig A,Ig M,and Ig G in the study group were higher than in the conventional group after treatment(P<0.05);Cdyn in the study group was higher and Fres,RAW,and PIP were lower than in the conventional group after treatment(P<0.05);there was no significant difference in the incidence of adverse reactions in the study group(11.11%)compared with the conventional group(19.05%)(P>0.05).Conclusion:Voriconazole sequential therapy can improve the clinical efficacy of patients with TB complicated with PA,effectively inhibit the inflammatory response,improving the immune function and lung function in patients,and has high safety.

关 键 词：肺结核 肺曲霉菌病 伏立康唑 序贯疗法 

分 类 号：R521[医药卫生—内科学]