CT在肺结核合并肺真菌感染的伊曲康唑治疗效果中的价值

目的探讨伊曲康唑治疗肺结核合并肺部真菌感染的临床疗效及CT在疗效评价中的价值。方法随机选取呼吸内科肺结核合并肺部真菌感染患者56例,患者均给予伊曲康唑联合抗结核治疗,并于治疗前后行CT检查,统计分析治疗1、2、6周的综合临床疗效、真菌学的疗效与实验室指标之间的变化;评价CT在疗效评估中的价值。结果治疗6周后的治疗有效率与真菌清除率分别为91.07%、89.29%,明显高于治疗1周与2周后,差异有统计学意义(均P<0.05);治疗后WBC(6.38±2.07)×109/L,(1,3)-β-D葡聚糖(17.86±8.74)ng/L,显著优于治疗前(t=6.98、56.21,P<0.05);治疗前后肝肾功能指标之间的比较差异无统计学意义;出现不良反应的患者低达4例(7.14%);治疗后的CT检查异常征象发生率显著低于治疗前(均P<0.05)。结论伊曲康唑治疗肺结核合并肺部真菌感染的疗效佳,无明显的肝肾功能损害,不良反应少,CT在疗效评价中具有重要的临床价值。

Objective To clinical curative effect of Itraconazole in treating pulmonary tuberculosis pulmonary fungus infection and evaluation value of CT. Methods 56 tuberculosis pulmonary fungus infection patients were selected randomly and given itraconazole combined tuberculosis treatment, CT examination, analyzed 1, 2, 6 weeks of treatment, clinical curative effect and mycological efficacy evaluation value of CT were compared. Results Efifcient treatment and fungal clearance after 6 weeks of treatment were 91.07%, 89.29%, which were signiifcantly higher than 1 week and 2 weeks of treatment （all P〈0.05）, WBC was （6.38 ± 2.07） ×109/L, （1,3）-β-D glucan was （17.86±8.74）ng/L, which was signiifcantly better than before treatment （t=6.98,56.21,P〈0.05）,liver and kidney function indexes differences before and after treatment had no statistical signiifcance, 4 patients（7.14%） happened adverse reactions. The CT signs abnormal rate after treatment was signiifcantly lower than before treatment （P〈0.05）. Conclusion Curative effect of itraconazole in treating pulmonary tuberculosis pulmonary fungus infection ,have no obvious damage of liver and kidney function, less adverse reactions, it is of important clinical value in curative effect evaluation to make CT examination.