氟康唑联合两性霉素B雾化吸入治疗老年糖尿病下呼吸道真菌感染的疗效分析

Clinical effect of aerosol inhalation of Amphotericin B and fluconazol in lower respiratory tract fungal infections in elderly diabetics

目的探讨氟康唑联合两性霉素B雾化吸入治疗老年糖尿病患者下呼吸道真菌感染的临床疗效及安全性。方法将46例老年糖尿病合并下呼吸道真菌感染的患者随机分为观察组和对照组各23例。观察组选用氟康唑0．2g，静脉滴注，1次／天或0．1g，口服，2次／天，同时联合两性霉素B25mg溶入灭菌注射用水20ml，每次取10～12．5ml雾化吸入，氧流量8～10L／rain，持续15～20分钟，2次／天，疗程10～14天。对照组单用氟康唑0．2g，静脉滴注，1次／天或0．1g，口服，2次／天，疗程10～14天。结果观察组、对照组有效率分别为82．6％和52．1％，两组比较差异有统计学意义（P〈0．05），不良反应发生率分别为13．0％和8．6％，两组比较差异无统计学意义（P〉0．05）。结论氟康唑联合两性霉素B雾化吸入治疗老年糖尿病合并下呼吸道真菌感染安全有效，不良反应少，值得临床推广。

Objective To investigate the clinical effect and safety of aerosol inhalation of Amphotericin B and fluconazol in lower respiratory tract fungal infections in elderly diabetics. Methods 46 elderly diabetics with lower respiratory tract fungal infections were randomly divided into therapy group and control group. In control group, the subjects were used flueonazole intravenous infusion of 0.2 g, 1 time a clay or 0.1 g orally,2 times a day. While in therapy group, the diabetics were not only used with fluconazole intravenous infusion of 0.2 g,1 time a day or 0.1 g orally,2 times a day, but also used amphoteriein B 25 mg sterile water for injection 20 ml, each taking 10 - 12.5 ml aerosol inhalation, oxygen flow rate 8 - 10 L/ min, continuous 15 -20 min ,2 times a day, 10 - 14 days of treatment. Results The clinical effective rate in trial group and control group were 82.6% and 52.1% （P 〈0.05） ,adverse reaction rates were 13.0% and 8.6% （ P 〉 0.05 ） respectively. Conclusions The aerosol inhalation of Amphotericin B and flueonazol is effective and safe in lower respiratory tract fungal infections in elderly diabetics.