伊曲康唑治疗真菌致敏严重支气管哮喘疗效与安全性研究

Effect and safety of itraconazole in treatment of severe bronchial asthma with fungus sensitivity

目的探讨伊曲康唑治疗真菌致敏的严重支气管哮喘(SAFS)的疗效与安全性。方法采用单中心、回顾性研究,收集2006—2011年上海市第一人民医院呼吸科就诊符合SAFS诊断标准并接受伊曲康唑抗真菌治疗的患者15例。记录SAFS患者在伊曲康唑治疗至少1个月后的肺功能、外周血嗜酸粒细胞数等指标,并与治疗前的各项指标作对照。结果完成6个月及以上治疗疗程的11例治疗后第1秒用力呼气容积(FEV1)增加了0.204 L(P<0.05),呼气峰流速(PEF)增加了0.55 L/min(P<0.05)。伊曲康唑治疗后平均住院次数(0.33±0.72)次,低于治疗前(1.33±1.45)次(P<0.05)。外周血嗜酸粒细胞下降了3.73%(P<0.05)。口服激素剂量下降了8.33 mg/d(P<0.05)。只有1例出现肝功能异常。结论伊曲康唑治疗SAFS有较好的疗效和临床安全性。

Objective To assess the effect and safety of itraconazole for severe bronchial asthma with fungus sensitivity （SAFS） patients. Methods A single-center retrospective study was done to screen the patients who met the criteria of SAFS from 2006 to 2011 in the Department of Respiratory Medicine of Shanghai First People＇s Hospital. The indicators such as lung function, Eos, and so on were recorded after the itraconazole therapy at least 1 month and then compared with the pre-treatment indicators. Data were analyzed using T test for related samples. Results Fifteen patients met the diagnostic criteria of SAFS. Only one subject experienced an abnormal liver function. FEVl was increased by 0. 2041 （ P = 0. 029 〈 0. 05 ） and PEF was increased by 0. 55 L/min （P = O. 015 〈 0. 05 ） in eleven subjects who completed at least 6-month treat- ment. Before treatment, the average number of hospitalization was 1.30 times, while the average number of hospitalization was O. 33 times after treatment （ P = O. 02 〈 O. 05 ）. Peripheral eosinophil counts were decreased by 3.73% （ P = 0.02 〈 0. 05）. Conclusion Itraconazole to SAFS patients had good clinical safety.