口服伊曲康唑治疗危重患者白色念珠菌肺部感染临床疗效观察

Clinical effect of itraconazole oral solutions on pulmonary candidiasis albicans in ICU patients

目的评估伊曲康唑口服制剂治疗重症监护病房(ICU)中危重患者白色念珠菌肺部感染的临床疗效。方法将2005年11月至2007年5月天津市第一中心医院ICU住院患者中痰培养为白色念珠菌者71例分为2组:伊曲康唑口服组36例,予伊曲康唑口服液200mg口服,每12h1次,疗程14d;氟康唑静脉制剂组35例,氟康唑静脉制剂首剂400mg静脉滴注,以后200mg静脉滴注,每日1次,疗程14d。结果伊曲康唑口服组完成总疗程者31例,真菌清除率64.52%(20/31),平均清除时间(10.12±2.57)d,有效率58.06%(18/31),痊愈率19.35%(6/31)。氟康唑静脉制剂组完成总疗程者29例,真菌清除率65.52%(19/29),平均清除时间(8.87±1.95)d,有效率62.07%(18/29),痊愈率17.24%(5/29)。伊曲康唑口服组与氟康唑静脉制剂组不良反应发生情况比较,差异无显著性意义,肝功能异常发生率分别为25.81%(8/31)和24.14%(7/29),经治疗无效停药者分别为3.23%(1/31)和6.90%(2/29)。结论伊曲康唑口服制剂治疗ICU白色念珠菌肺部感染疗效确切,且用药方便、安全、副反应低。

Objective To evaluate the clinical effect of itraconazole oral solutions on pulmonary candidiasis albicans in ICU patients, Methods A total of 71 patients with candida abllcans in their sputum clutures were randomized into two groups. The itraconazole group （ n = 36 ） received itraconazole 200 mg, p. o. （ including nasal feeding）, q12h for 14 days. The fluconazole group（ n = 35）received fluconazole 400 mg for the first dose,then 200 mg,i. v. drip,qd for 14 days. Resuits There were 31 patients in the itraconazole group and 29 paitents in the fluconazole group who completed their treatment. In the itraconazole and fluconazole group, the clearance of candida ablicans was 64. 52% （20/31 ）vs. 65.55% （ 19/ 29） ,cleaning time（ 10. 12 ±2. 57） vs（ 8. 87 ±1. 95） days,effective rate 58.06% （ 18/31 ） vs 62. 07% （ 18/29 ） ,recovery rate is 19. 35 % （6/31 ） vs 17.24% （5/29）, occurrence of hepatic dysfunction is 25.81% （ 8/31 ） vs 24. 14% （7/29）, and withdrawal for inefficacy was 3.23% （ 1/31 ）vs 6.90% （2/29）, respectively. These parameters did not have statistical significance. Conclusion Itraconazole oral solutions can be used effectively and safely in the treatment of pulmonary candidiasis albicans in ICU. Patients with renal dysfunction do not need to adjust the dosage.