不同疗程静脉伏立康唑治疗侵袭性肺曲霉菌感染的疗效比较

The comparative study on effects of different courses of intravenous voriconazole in treatment of invasive pulmonary aspergillosis

目的观察不同疗程静脉伏立康唑治疗侵袭性肺曲霉菌病的疗效及安全性。方法42例侵袭性肺曲霉菌病患者随机分为对照组与观察组，各21例。首日均给予患者伏立康唑6mg／kg，每12h给药1次，之后每次4mg／kg，2次／d，静脉滴注。对照组持续用药7d，观察组持续用药14d；症状缓解后均改为13服伏立康唑。观察2组患者临床症状、体征的变化。结果治疗结束后，观察组患者胸痛、咳血、紫绀、咳痰、呼吸困难症状发生率均低于对照组，差异有统计学意义（P〈0．05，P〈0．01）；观察组总有效率100．0％高于对照组的71．4％，差异有统计学意义（P〈0．05）；2组患者不良反应发生率差异无统计学意义（P〉0．05）。结论长时间应用伏立康唑治疗侵袭性肺曲菌病疗效优于短时间应用，且未增加不良反应。

Objective To observe the effect of different courses of intravenous voriconazole in treatment of invasive pulmonary aspergillosis. Methods A total of 42 patients with invasive pulmona- ry aspergillosis were randomly divided into control group （n = 21 ） and observation group （n = 21 ）. The intravenous voriconazole with a dosage of 6 4 mg/kg, 2 times per day with the following days. mg/kg , 1 time every 12 hours, on first day and The courses of treatment were 7 day and 14 days in control and observation group, respectively. The changes in clinical sign were observed between two groups. Results The incidence of stethalgia, hemoptysis, in observation group than those in control group （ P 〈 0.05, cyanosis, sputum and dyspnea were lower P 〈0.01 ）. The overall effective rate was 100.0% in observation group and 81.0% in control group, with a significant difference （P 〈 0.05）. there was no significant difference in incidence of adverse reaction between two groups （ P 〉 0.05 ）. Conclusion Intravenous voriconazole with long term course （14 days） is more effective, without in- creased adverse reaction, in treatment of invasive pulmonary aspergillosis.