两性霉素B治疗COPD合并侵袭性肺曲霉菌病的相关性研究

Correlation of amphotericin B in the treatment of COPD patients complicated with invasive pulmonary aspergillosis

目的对比两性霉素B与伊曲康唑治疗C0PD合并侵袭性肺曲霉菌病(IPA)的临床疗效、不良反应及治疗费用。方法对比研究我院两性霉素B治疗COPD合并IPA的52例患者诊疗过程与伊曲康唑治疗COPD合并IPA的25例患者诊疗过程。结果两性霉素B治疗COPD合并IPA有效率70.2%,不良反应发生率53.1%,主要是低血钾(44.7%),寒战发热(31.9%),中位疗程29天,治疗经费1820元,7例中途放弃治疗(14.9%);伊曲康唑治疗COPD合并IPA有效率68.4%,不良反应发生率10.5%,均为轻度肝功能异常(5.3%),中位疗程26天,治疗经费28000元,6例中途放弃治疗(24%)。结论与伊曲康唑相比,两性霉素B治疗COPD合并IPA疗效肯定,不良反应发生率高,但无严重不良反应,且治疗经费低,患者能坚持治疗,是较为安全有效的一线抗真菌药物。

Objective To compare the clinical curative effect and safety of amphotericin B and Itraconazole＆amp;nbsp;on COPD patients complicated with invasive pulmonary aspergillosis （IPA）. Methods A total of 52 COPD patients complicated with IPA received domestic amphotericin B treatment （ the group A） , and 25 patients received Itracon-azole （ the group B） from 2008 to 2014 in our hospital. Results In the group A, the total effective rate was 70. 2%and the total side effect rate was 53. 1%. The most common adverse reactions were hypokalemia （ 44. 7%） , fever （31. 9%） and slightly kidney injury （14. 6%）. It cost 1820 yuan, and 7 cases of them （14. 9%） quitted the treat-ment. In the group B, the total effective rate was 68. 4% and the total side effect rate was 10. 5%. The adverse reac-tions included mildly liver damage. It took 28000 yuan, and 6 cases （24%） quitted. Conclusion Compared with Itraconazole, amphotericin B is effective in the treatment of COPD patients complicated with invasive pulmonary as-pergillosis. The incidence of adverse reactions was higher, but it didn’ t result serious side effect.