丙种球蛋白在治疗慢性阻塞性肺疾病合并真菌感染中的作用

Role of immunoglobulin in treating chronic obstructive pulmonary disease with fungal infection

目的探讨静脉用丙种球蛋白(IVIG)治疗慢性阻塞性肺疾病(COPD)合并真菌感染的临床价值。方法72例临床诊断为COPD合并真菌感染的患者入选,被随机分为常规组和干预组,每组36例。常规组给予抗感染、平喘及抗真菌药物治疗;干预组在上述治疗基础上,加用IVIG,每日1次,每次10 g。根据患者的临床症状改善情况,进行疗效评价,记录患者住院时间及预后。结果干预组的治疗有效率为88.89%(32/36),明显高于常规组的66.67%(24/36);平均住院时间为(12.62±7.51)d,明显短于常规组的(20.81±6.92)d;病死率为5.56%(2/36),低于常规组的22.22%(8/36),差异均有统计学意义(均P<0.05)。结论 IVIG治疗COPD合并真菌感染可提高临床疗效,缩短患者住院时间,降低病死率。

Objective To explore the clinical effect of intravenous immunoglobulin（IVIG）on chronic obstructive pulmonary disease（COPD）and fungal infection.Methods Seventy-two COPD patients with fungal infection were randomly and equally divided into conventional and intervention group.Patients in conventional group were treated with common schedule for COPD plus antifungal agents;patients in intervention group received 1 0 g/d IVIG besides routine therapy.Length of hospital stay and prognosis were recorded,and therapeutic effectiveness were evaluated. Results The effectiveness rate of intervention group was significantly higher than that of conventional group （[88.89%,32/36]vs [66.67%,24/36]）;the average length of hospital stay was significantly shorter than conven-tional group （[12.62±7.51]d vs [20.81±6.92]d）,and mortality was lower than conventional group （[5.56%, 2/36]vs [22.22%,8/36]）,the differences were statistically significant （P〈0.05）.Conclusion IVIG for treating COPD with invasive pulmonary fungal infection can improve therapeutic efficacy,shorten length of hospital stay and decrease mortality rate.