CAJ | 학술논문

目的观察伊曲康唑注射液治疗老年慢性肺部疾病者肺部急性侵袭性真菌感染(IFI)的临床效果与心脏安全性.方法单中心、开放试验设计.选择70岁以上慢性肺部疾病基础上发生肺部In的患者,静脉应用伊曲康唑注射液治疗,观察用药14 d的临床有效性和心脏安全性.结果 35例患者纳入本研究,确诊3例,临床诊断32例;合并冠心病26例,肺心病20例,同时合并冠心病和肺心病17例.治疗14 d后,体温于7 d内降至正常的22例,11 d降至正常的3l例;14 d后血1,3-13.D葡聚糖水平降至正常的26例(78.79%);5例病原学为白念珠菌者x线胸片示原有病灶完全吸收.2例患者分别于治疗第4天、第5天出现左心功能不全表现伴室性心律失常,对症处理后均于次Et心力衰竭症状完全消失.治疗前后血B型利钠肽(BNP)水平在正常范围的例数比较差异有统计学意义(P<0.01).结论伊曲康唑注射液治疗老年慢性肺部疾病基础上发生的肺部IFI 14 d临床有效率为78.79%;即使合并冠心病、肺心病的老年慢性肺部疾病患者应用该药14 d内也是比较安全的.
목적 관찰이곡강서주사액치료노년만성폐부질병자폐부급성침습성진균감염(IFI)적림상효과여심장안전성.방법 단중심、개방시험설계.선택70세이상만성폐부질병기출상발생폐부In적환자,정맥응용이곡강서주사액치료,관찰용약14 d적림상유효성화심장안전성.결과 35례환자납입본연구,학진3례,림상진단32례;합병관심병26례,폐심병20례,동시합병관심병화폐심병17례.치료14 d후,체온우7 d내강지정상적22례,11 d강지정상적3l례;14 d후혈1,3-13.D포취당수평강지정상적26례(78.79%);5례병원학위백념주균자x선흉편시원유병조완전흡수.2례환자분별우치료제4천、제5천출현좌심공능불전표현반실성심률실상,대증처리후균우차Et심력쇠갈증상완전소실.치료전후혈B형리납태(BNP)수평재정상범위적례수비교차이유통계학의의(P<0.01).결론 이곡강서주사액치료노년만성폐부질병기출상발생적폐부IFI 14 d림상유효솔위78.79%;즉사합병관심병、폐심병적노년만성폐부질병환자응용해약14 d내야시비교안전적.
Objective To observe the clinical efficiency and cardiac safety of itraconazole injection in the treatment of the elderly patients with chronic pulmonary diseases suffered from acute pulmonary invasive fungal infection (IFI). Methods The research was single centre and open experimental designed trial. We selected patients ( >70 years old) who were admitted to our department of respiratory medicine because of chronic pulmonary diseases combined with pulmonary IFI. All patients received intravenous itraconazole injection. The clinical efficiency and cardiac safety wag observed for 14 days. Results Thirty-five patients were included.3 patients were proven.32 patients were probable. There were 26 patients combined with coronary artery disease (74.28%), 20 patients combined with cor pulmonale (57.14%), and 17 patients simultaneously combined with both (48.57%). The temperature of 22 patients (62.86%) decreased to normal in 7 days, 31 patients (90.39%) in 11 days. After 14 days' therapy, the leval of 1,3-β-D glucan decreased to normal in 26 patients (78.79%). The foci in sternum of 5 patients who were infected by candida albicans were completely absorbed in 14 days. Two patients were suffered from left heart insufficiency and arrhythmia ventricular on the 4th and 5th day respectively, and disappeared on the next day after given symptomatic treatment. There was a significant difference in B-type natriuretic peptide (BNP) between before and after treatment. Conclusion The clinical efficiency of itraconazole injection in the elderly patients who suffered from chronic pulmonary diseases and then combined with acute pulmonary IFI were 78.79%. Even if combined with coronary artery disease and/or cor pulmonale, the elderly patients who have chronic pulmonary diseases were safe when using the itraconazole injection in 14 days.