伏立康唑治疗老年肺曲霉病的安全性分析

Safety of Voriconazole for treatment of pulmonary aspergillosis in elderly patients

目的观察伏立康唑治疗老年侵袭性肺曲霉病的临床疗效和安全性,为临床治疗提供依据。方法回顾性分析29例老年侵袭性肺曲霉病的患者予伏立康唑首日6 mg/(kg.次),1次/12 h,以后每次4 mg/(kg.次),2次/d,静脉滴注治疗,疗程视患者用药后的临床症状和微生物学反应而定,观察临床疗效及不良反应。结果伏立康唑治疗老年侵袭性肺曲霉病患者29例,痊愈8例,显效11例,进步5例,无效5例(其中死亡2例)。有效率为65.5%。6例患者出现不良反应,发生率为20.6%,仅2例停药。结论本研究初步提示,伏立康唑作为一种新型的抗真菌药物,其高效安全的特点有望使其成为治疗老年侵袭性肺曲霉病的一线药物。

To observe the clinical efficacy and safety of Voriconazole for treatment of pulmonary aspergillosis in elderly patients,and provide evidence for clinical therapy.【Methods】Retrospectively investigated 29 cases of aggressive pulmonary aspergillosis in elderly patients treated with Voriconazole.Initial dose was 6 mg/（kg.12 h）,maintenance control with 4 mg/kg,twice per day by intravenous drip.Duration of treatment was determined by the change of clinical symptoms and results of microbial tests after treatment.Observe the clinical efficacy and adverse drug reactions.【Results】Among the 29 cases of aggressive pulmonary aspergillosis treated with Voriconazole,8 were cured,11 had marked effect,5 were improved and 5 were ineffective including 2 death cases,with a effective rate of 65.5%.6 patients had adverse drug effects（ADRs）,the total rate of ADRs being 20.6%.The treatment of 2 patients was interupted.【Conclusions】This study demonstrated that Voriconazole,as a novel antifungal agent,was expected to become the first line drug in treatment of aggressive pulmonary aspergillosis in elderly patients for its high efficacy and safety.