米卡芬净与卡泊芬净分别联合复方磺胺甲噁唑治疗耶氏肺孢子菌肺炎的疗效、安全性和药物经济学评价  

Evaluation of the efficacy,safety and pharmacoeconomics of micafungin and caspofungin respectively combined with trimethoprim⁃sulfamethoxazole in the treatment of Pneumocystis jirovecii pneumonia

作　　者：张佳瑞 周景润 曹裕孟 王玲[1] 樊永威 王昭汐 张固琴[1] ZHANG Jiarui;ZHOU Jingrun;CAO Yumeng;WANG Ling;FAN Yongwei;WANG Zhaoxi;ZHANG Guqin(Dept.of Respiratory and Critical Care Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院呼吸与危重症医学科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2024年第11期1370-1373,1385,共5页Medical Journal of Wuhan University

基　　金：中华国际医学交流基金会资助项目(编号:Z-2017-24-2110)。

摘　　要：目的:评价米卡芬净与卡泊芬净分别联合复方磺胺甲噁唑治疗耶氏肺孢子菌肺炎的疗效、安全性和药物经济学。方法:回顾性收集2013年1月—2023年4月武汉大学中南医院收治的耶氏肺孢子菌肺炎病人的临床资料。根据用药情况不同从中筛选出卡泊芬净联合复方磺胺甲噁唑组(卡泊芬净组)123例、米卡芬净联合复方磺胺甲噁唑组(米卡芬净组)27例。比较两组患者的疗效、不良反应和药物经济学。结果:米卡芬净组和卡泊芬净组的治疗总有效率分别为70.37%和71.83%,两组总有效率差异无统计学意义(P>0.05)。米卡芬净组和卡泊芬净组不良反应总发生率分别为18.52%和14.63%,两组比较差异无统计学意义(P>0.05)。米卡芬净组日用药金额中位数为384.0元,卡泊芬净组为912.0元,两组比较差异有统计学意义(P<0.001)。结论:米卡芬净与卡泊芬净分别联合复方磺胺甲噁唑用于治疗耶氏肺孢子菌肺炎,两者疗效相似,不良反应发生率接近。二者在疗效和不良反应相当的情况下,从经济学角度考虑米卡芬净更具优势。Objective:To evaluate the efficacy,safety and pharmacoeconomics of micafungin and caspofun⁃gin in combination with trimethoprim⁃sulfamethoxazole in the treatment of Pneumocystis jirovecii pneumonia.Methods:We collected the clinical data of the patients with Pneumocystis jirovecii pneu⁃monia admitted to Zhongnan Hospital of Wuhan University from January 2013 to April 2023.Of the patients involved in this study,123 cases were treated with the combination of caspofungin and trime⁃thoprim⁃sulfamethoxazole(caspofungin group),and 27 cases were treated with the combination of mi⁃cafungin and trimethoprim⁃sulfamethoxazole(micafungin group).The efficacy,adverse reactions,and pharmacoeconomics between the two groups were compared. Results: The total effective rates of themicafungin group and the caspofungin group were 70. 37% and 71. 83%, respectively, without statis⁃tically significant difference (P>0. 05). The total incidence of adverse reactions in the micafungingroup and the caspofungin group was 18. 52% and 14. 63%, respectively, and no statistically signifi⁃cant difference was found too (P>0. 05). But the daily medicine expenses showed significant differ⁃ence between the two groups as median 384. 0 yuan for micafungin group versus 912. 0 yuan for caspo⁃fungin group, respectively, with statistically significant difference (P<0. 001). Conclusion: Micafun⁃gin and caspofunginare in combination with trimethoprim⁃sulfamethoxazole are similar both in efficacyand adverse reactions when they were adopted in the treatment of Pneumocystis jirovecii pneumonia.From an economic perspective, micafungin is more advantageous when the efficacy and adverse reac⁃tions of the two are comparable.

关 键 词：米卡芬净 卡泊芬净 耶氏肺孢子菌肺炎 药物经济学 

分 类 号：R56[医药卫生—呼吸系统]