中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
14期
90-92,95
,共4页
血液病%呼吸道侵袭性真菌感染%氟康唑%伊曲康唑%两性霉素
血液病%呼吸道侵襲性真菌感染%氟康唑%伊麯康唑%兩性黴素
혈액병%호흡도침습성진균감염%불강서%이곡강서%량성매소
Blood disease%Invasive fungal infection of respiratory tract%Fluconazole%Itraconazole%Amphotericin
目的:探讨血液病并呼吸道侵袭性真菌感染的临床特征和疗效的影响因素。方法选择96例血液病合并侵袭性呼吸道真菌感染患者,根据药物治疗方法不同分为氟康唑组(n=30)、伊曲康唑组(n=45)、两性霉素组(n=21)。分析血液病合并侵袭性呼吸道真菌感染的临床表现、CT表现、微生物检查情况,比较三组临床疗效,临床疗效的影响因素、三组不良反应发生情况。结果伊曲康唑组、两性霉素组的总有效无统计学差异,但均明显高于氟康唑组(P<0.05),两性霉素组痊愈率均明显高于氟康唑组、伊曲康唑组(P<0.05)。原发病进展对临床疗效影响明显,而年龄、粒细胞缺乏期、药物治疗时间与临床疗效无明显关系。氟康唑组肝损害发生率明显高于伊曲康唑组、两性霉素组,伊曲康唑组的消化道反应发生率明显高于氟康唑组、两性霉素组,两性霉素组肾损害、寒战高热、低钾血症发生率明显高于氟康唑组、伊曲康唑组,差异有统计学意义(P<0.05)。结论血液病并呼吸道侵袭性真菌感染以肺部感染为多,病原菌多为念珠菌属,氟康唑疗效较差,而伊曲康唑或两性霉素疗效较好,但两性霉素由于不良反应较多,因此在应用时需慎重选择。
目的:探討血液病併呼吸道侵襲性真菌感染的臨床特徵和療效的影響因素。方法選擇96例血液病閤併侵襲性呼吸道真菌感染患者,根據藥物治療方法不同分為氟康唑組(n=30)、伊麯康唑組(n=45)、兩性黴素組(n=21)。分析血液病閤併侵襲性呼吸道真菌感染的臨床錶現、CT錶現、微生物檢查情況,比較三組臨床療效,臨床療效的影響因素、三組不良反應髮生情況。結果伊麯康唑組、兩性黴素組的總有效無統計學差異,但均明顯高于氟康唑組(P<0.05),兩性黴素組痊愈率均明顯高于氟康唑組、伊麯康唑組(P<0.05)。原髮病進展對臨床療效影響明顯,而年齡、粒細胞缺乏期、藥物治療時間與臨床療效無明顯關繫。氟康唑組肝損害髮生率明顯高于伊麯康唑組、兩性黴素組,伊麯康唑組的消化道反應髮生率明顯高于氟康唑組、兩性黴素組,兩性黴素組腎損害、寒戰高熱、低鉀血癥髮生率明顯高于氟康唑組、伊麯康唑組,差異有統計學意義(P<0.05)。結論血液病併呼吸道侵襲性真菌感染以肺部感染為多,病原菌多為唸珠菌屬,氟康唑療效較差,而伊麯康唑或兩性黴素療效較好,但兩性黴素由于不良反應較多,因此在應用時需慎重選擇。
목적:탐토혈액병병호흡도침습성진균감염적림상특정화료효적영향인소。방법선택96례혈액병합병침습성호흡도진균감염환자,근거약물치료방법불동분위불강서조(n=30)、이곡강서조(n=45)、량성매소조(n=21)。분석혈액병합병침습성호흡도진균감염적림상표현、CT표현、미생물검사정황,비교삼조림상료효,림상료효적영향인소、삼조불량반응발생정황。결과이곡강서조、량성매소조적총유효무통계학차이,단균명현고우불강서조(P<0.05),량성매소조전유솔균명현고우불강서조、이곡강서조(P<0.05)。원발병진전대림상료효영향명현,이년령、립세포결핍기、약물치료시간여림상료효무명현관계。불강서조간손해발생솔명현고우이곡강서조、량성매소조,이곡강서조적소화도반응발생솔명현고우불강서조、량성매소조,량성매소조신손해、한전고열、저갑혈증발생솔명현고우불강서조、이곡강서조,차이유통계학의의(P<0.05)。결론혈액병병호흡도침습성진균감염이폐부감염위다,병원균다위념주균속,불강서료효교차,이이곡강서혹량성매소료효교호,단량성매소유우불량반응교다,인차재응용시수신중선택。
Objective To investigate the clinical features and influence factors of curative effect in blood disease com-plicated with invasive fungal infection of respiratory tract. Methods A total of 96 patients with blood disease compli-cated with invasive fungal infection of respiratory tract were selected.According to difference of drug treating methods,they were divided into fluconazole group (n=30),itraconazole group(n=45),amphotericin group(n=21). The clinical manifestations,CT performance, microorganism spection of blood disease complicated with invasive fungal infection of respiratory tract were analyzed, the clinical effect among three group were compared,influence factors about clinical efficacy were analyzed,the occurrence of adverse reaction among three groups were compared. Results The total effec-tive in itraconazole group and amphotericin group had no statistical significance.but those were obviously higher than those in fluconazole group (P<0.05).The cure rate in amphotericin group were obviously higher than those in flucona-zole group and itraconazole group(P<0.05). the progress of primary disease had obvious effects on clinical curative ef-fect. while age,agranulocytosis phase,drug treatment time had no obvious relationship with clinical curative effect. The incidence of liver damage in fluconazole group was obviously higher than that in itraconazole group and amphotericin group, The incidence of gastrointestinal reaction in itraconazole group was obviously higher than that in fluconazole group and amphotericin group. The incidence of renal injury,fever,hypokalemia in amphotericin group were obviously higher than those in fluconazole group and itraconazole group. The differences were statistically significant(P<0.05). Conclusion Blood disease complicated with invasive fungal infection of respiratory tract is mainly pulmonary infection. Pathogenic bacteria is mainly candida, the clinical effect of fluconazole is poor while clinical effect of itraconazole or amphotericin is better,but amphotericin is due to much adverse reactions,therefore,it needs to carefully select in appli-cation.