伊曲康唑治疗重症监护患者侵袭性真菌感染的临床观察

Clinical Efficacy of Itraconazole in the Treatment of Invasive Fungal Infections in Patients of Intensive Care Unit

目的:观察伊曲康唑治疗重症监护室(ICU)患者侵袭性真菌感染的临床疗效和安全性。方法:回顾性分析2009年1月～2009年9月入住上海交通大学医学院附属新华医院急诊ICU的21例侵袭性真菌感染患者,经伊曲康唑治疗的疗效及安全性。结果:总临床治愈率为52.3%;培养所得的103例菌株均进行药物敏感性试验,结果显示均对伊曲康唑敏感,其总细菌清除率为57.1%;确诊及临床诊断病例、拟诊病例的临床治愈率分别为33.3%、56.2%、50.0%,细菌清除率分别为33.3%、62.5%、50.0%。药品不良反应总发生率为14.2%。结论:伊曲康唑治疗重症监护患者侵袭性真菌感染安全有效,但心功能不全患者应慎用,使用过程中需监测生命体征、病情变化。

OBJECTIVE：To observe clinical efficacy and safety of itraconazole in the treatment of invasive fungal infections（IFI） in patients of intensive care unit（ICU）.METHODS：21 patients with IFI in ICU of Xinhua Hospital were analyzed retrospectively from Jan.to Sep.in 2009.Clinical efficacy and safety of itraconazole were analyzed.RESULTS：The total clinical cure rate reached 52.3%.Drug sensitivity test of 103 cases of bacterial strain culture showed those bacterial strains was sensitive to itraconazole.Total clearance rate of bacterial was 57.1%.Cure rate of confirmed diagnosis cases,clinical diagnosis cases and suspected cases were 33.3%,56.2% and 50.0%.The clearance rates of bacteria in above cases were 33.3%、62.5% and 50.0%.The incidence of ADR was 14.2%.CONCLUSION：Itraconazole is effective and safe in the treatment of IFI in patients of ICU.However,the patients with cardio dysfunction should be treated carefully with itraconazole.It is necessary to monitor vital sign and observe the change of symptom during medication.