卡泊芬净与依曲康唑口服溶液序贯治疗侵袭性真菌感染的疗效与安全性

Efficacy and Safety of Caspofungin Followed by Itraconazole Oral Solution for Patients with Invasive Fungal Infection

目的评价醋酸卡泊芬净静脉注射后口服伊曲康唑治疗重症监护病房（ICU）侵袭性真菌感染（IFI）疗效与安全性。方法将42例侵袭性真菌感染患者,根据不同抗真菌治疗方法分成两组,治疗组24例,给予醋酸卡泊芬净,首日70 mg,次日起50 mg.d-1,加入0.9%氯化钠注射液中静脉滴注,时间〉1 h,2~4周后,改为口服伊曲康唑口服液;对照组18例,静脉滴注卡泊芬净,首日70 mg,次日起50 mg.d-1,完成全部疗程。观察两组患者的疗效与不良反应发生情况。结果治疗组治愈5例,显效10例,进步3例,无效6例。发生不良反应2例;对照组治愈5例,显效7例,进步2例,无效4例。发生不良反应3例。结论两种方案对侵袭性真菌感染的患者均有效,卡泊芬净静脉滴注后改用口服伊曲康唑有较好的疗效,且安全性好,不良反应少。

Objective To evaluate the efficacy and safety of caspofungin and itraconazole on treating invasive fungal infection（IFI） in intensive care unit（ICU）. Methods 42 patients with IFI were divided into two groups by different treatment： 24 patients in the treatment group were i.v.injected with caspofungin 70 mg·d-1 at day 1 and 50 mg·d-1 in N.S.later on,over 1 h,with itraconazole oral solution instead 2-4 weeks later;18 in control group were i.v.treated with caspofungin 70 mg·d-1for the first day,and 50 mg·d-1 since then till the end.The therapeutic effect and side effects in two groups were observed. Results 5 patients in the treatment group were cured,10 showed effective,3 were advanced,6 were invalid,and 2 cases of side effects occured;5 were cured in the control group,7 showed effective,2 were advanced,4 were invalid,3 cases of side effects were observed. Conclusion The both regimes are effective for IFI,i.v.caspofungin followed with itraconazole is effect and safe,with fewer side reactions.