卡泊芬净与伏立康唑治疗侵袭性真菌感染的疗效观察

Observation on Efficacy of Caspofungin and Voriconazole in Treatment of Patients with Severe Invasive Fungal Infections

目的:探讨卡泊芬净和伏立康唑治疗侵袭性真菌感染临床疗效。方法:选取侵袭性真菌感染患者100例,按随机数字表法分为观察组与对照组各50例。观察组患者给予注射用卡泊芬净(70 mg负荷剂量、50 mg维持剂量)静脉滴注,对照组患者给予注射用伏立康唑(400 mg负荷剂量、200 mg维持剂量)静脉滴注,比较2组患者的临床疗效。结果:观察组患者的痊愈率为44.00%(22/50)、总有效率为86.00%(43/50),高于对照组的32.00%(16/50)、74.00%(37/50),差异均有统计学意义(P<0.05);观察组患者平均住院时间、平均住院费明显低于对照组,细菌清除率明显高于对照组,差异均有统计学意义(P<0.05);治疗第4日,观察组患者的白细胞计数、C反应蛋白、降钙素原下降幅度明显高于治疗前,且明显优于对照组,差异有统计学意义(P<0.05);2组患者肝、肾功能均无明显变化。结论:卡泊芬净治疗重症患者侵袭性真菌感染疗效肯定,不良反应轻,可用于重症患者抗真菌治疗。

OBJECTIVE：To probe into the clinical efficacy of caspofungin and voriconazole in treatment of patients with severe invasive fungal infections.METHODS：100 cases of invasive fungal infections were selected to be divided into observation group and control group via random number table, with 50 cases in each.The observation group were treated with caspofungin （70 mg loading dose, 50 mg maintenance dose） intravenous infusion, while the control group were given voriconazole （400 mg loading dose, 200 mg maintenance dose） intravenous infusion;the clinical efficacy were compared between two groups.RESULTS： The recovery rate of observation group was 44.00%（ 22/50 ） , the total effective rate was 86.00%（43/50）, higher than those of control group 32.00%（16/50） and 74.00%（37/50）, with statistically significant difference （ P 〈0.05 ） .The average hospitalization time, average hospitalization cost of observation group were significantly lower than those of control group, yet the rate of bacteria clearance was higher than that of control group, with statistically significant difference （ P〈0.05 ） .After treatment of 4 days, the decrease of numeration of leukocyte, C reactive protein and procalcitonin in observation group was more significant than that of before group, and significantly higher than that of control group, with statistically significant difference （ P〈0.05 ） . There were few changes in liver and kidney function in two groups.CONCLUSIONS： The efficacy of caspofungin in treatment of patients with severe invasive fungal infections is significant, with few adverse drug reactions, which can be used for patients with severe anti-fungal therapy.