卡泊芬净辅助治疗对HIV合并肺孢子菌肺炎患者的疗效及对BDG、KL-6水平的影响  

Effectiveness of caspofungin as an adjunctive treatment in HIV patients with pneumocystis pneumonia and its impact on BDG and KL-6 levels

作　　者：文小平 邹美银[1] 朱晓红[1] 曹力[1] 吴丛霞[1] WEN Xiaoping;ZOU Meiyin;ZHU Xiaohong;CAO Li;WU Congxia(Department of Infectious Diseases,Third People's Hospital of Nantong(Affiliated Third Hospital of Nantong University),Nantong,Jiangsu 226000,China)

机构地区：[1]南通市第三人民医院(南通大学附属第三医院)感染科,江苏南通226000

出　　处：《中国国境卫生检疫杂志》2025年第1期89-91,共3页Chinese Journal of Frontier Health and Quarantine

基　　金：江苏省卫生健康委科研项目(H2021073);南通市自然科学基金和社会民生科技计划项目(MSZ2023129)。

摘　　要：目的探究卡泊芬净辅助复方磺胺甲噁唑对人类免疫缺陷病毒(HIV)合并肺孢子菌肺炎患者疗效、血气指标、免疫指标、生化指标及不良反应的影响。方法选取2020年1月—2024年1月南通市第三人民医院接收的120例HIV合并肺孢子菌肺炎患者,按信封抽签法随机分为对照组(n=60)和辅助治疗组(n=60)。对照组给予复方磺胺甲噁唑治疗,辅助治疗组在对照组的基础上辅助卡泊芬净治疗,比较两组的临床疗效、治疗前后的动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))及血清乳酸脱氢酶(LDH)、1,3-β-D葡聚糖(BDG)、涎液化糖链抗原-6(KL-6)水平。结果治疗后,辅助治疗组的临床疗效总有效率(96.7%)高于对照组(85.0%)(P<0.05);辅助治疗组的PaO_(2)[(145.23±3.98)mm Hg]、SpO_(2)[(95.78±1.85)%]高于对照组,PaCO_(2)(31.27±2.87mmHg)低于对照组(t=31.384、5.159、9.567,P<0.05);辅助治疗组的CD4^(+)T淋巴细胞[(39.22±4.07)%]高于对照组,CD8^(+)T淋巴细胞[(22.33±2.46)%]低于对照组(t=5.365、8.531,P<0.05);辅助治疗组的LDH为(322.63±42.26)U/L、BDG为(289.33±31.20)pg/ml、KL-6为(570.56±94.05)U/ml,均低于对照组(t=15.253、11.866、10.788,P<0.05)。结论卡泊芬净辅助治疗对HIV合并肺孢子菌肺炎患者的疗效及对BDG、KL-6水平的影响较为显著。Objective To investigate the effects of caspofungin combined with sulfamethoxazole-trimethoprim on the efficacy,blood gas indices,immune indices,biochemical indices and adverse reactions in patients with human immunodeficiency virus(HIV)infection complicated with pneumocystis pneumonia(PCP).Methods A total of 120 patients with HIV complicated with pneumocystis pneumonia,admitted to Third People’s Hospital of Nantong between January 2020 and January 2024,were randomly divided into the control group(n=60)and adjunct treatment group(n=60)by using envelope randomization method.The control group was treated with sulfamethoxazole-trimethoprim,while the adjunct treatment group received additional caspofungin.The clinical efficacy,arterial oxygen partial pressure(Pa O_(2)),arterial carbon dioxide partial pressure(Pa CO_(2)),oxygen saturation(SpO_(2)),serum lactate dehydrogenase(LDH),1,3-β-D-glucan(BDG)and krebs von den lungen-6(KL-6)levels were compared between the two groups before and after treatment.Results After treatment,the total effective rate in the adjunct treatment group(96.7%)was higher than that in the control group(85.0%)(P<0.05).PaO_(2),SpO_(2)was(145.23±3.98)mm Hg,(95.78±1.85)%in the adjunct treatment group,Pa CO_(2)[(31.27±2.87)mmHg]was lower than the control group(t=31.384,5.159,9.567,P<0.05).The CD4^(+)T lymphocyte level[(39.22±4.07)%]in the adjunct treatment group was higher than the control group,while CD8^(+)T lymphocyte level[(22.33±2.46)%]was lower than the control group(t=5.365,8.531,P<0.05).LDH,BDG,KL-6 of the adjunct treatment group was(322.63±42.26)U/L,(289.33±31.20)pg/ml,(570.56±94.05)U/ml,were all lower than control group(t=15.253,11.866,10.788,P<0.05).Conclusion As an ad junct treatment,caspofungin could significantly improve outcomes of patients with HIV infection and pneumocystis pneumonia,notably affecting BDG and KL-6 levels.

关 键 词：卡泊芬净 人类免疫缺陷病毒 肺孢子菌肺炎 1 3-β-D葡聚糖 涎液化糖链抗原-6 

分 类 号：R512.911[医药卫生—内科学]