伏立康唑治疗恶性肿瘤放化疗后肺侵袭性真菌感染疗效分析

Clinical effect of voriconazole in the treatment of invasive fungai infections in lung cancer patients with radiotherapy and chemotherapy

目的探讨伏立康唑治疗恶性肿瘤放化疗后肺侵袭性真菌感染临床效果及安全性，为临床治疗提供参考。方法回顾性分析64例恶性肿瘤放化疗后肺侵袭性真菌感染患者的临床资料，按照治疗方法分为对照组与观察组，各32例。对照组使用氟康唑治疗，观察组使用伏立康唑治疗。对比两组治疗有效率、白细胞等指标恢复正常时间、肝肾功能。结果观察组有效率为81．25％，明显高于对照组的68．75％，差异有统计学意义（χ2=5．876，P=0．008）；观察组体温恢复、咳嗽消失、白细胞恢复时间分别为（3．61±0．61）d、（6．11±0．81）d、（7．85±0．92）d，均明显短于对照组，差异均有统计学意义（t=4．145，P=0．025；t=4．045，P=0．027；t=4．385，P=0．021）；两组治疗均有轻度肝肾功能损害，但两组差异无统计学意义（均P〉0．05）。结论伏立康唑治疗恶性肿瘤放化疗后肺侵袭性真菌感染临床效果好，治疗周期短，但肝肾功能有轻度损害，治疗期间应加强监测。

Objective To investigate the clinical effect of voriconazole in the treatment of invasive fungal infections in lung cancer patients with radiotherapy and chemotherapy, to provide a reference for clinical treatment. Methods The clinical data of 64 lung cancer patients with radiotherapy and chemotherapy with invasive fungal infec- tions were retrospectively analyzed. According to the treatment methods, they were divided into control group and observation group,32 cases in each group. Fluconazole treatment was used in the control group, and the observation group used voriconazole therapy. The overall response rate, time to return to normal white blood cells and other indica- tors of liver and kidney function were compared between the two groups. Results The effective rate of the observation group was 81.25% ,which was significantly higher than 68.75% of the control group,the difference was statistically significant（ X2 = 5. 876, P = 0. 008 ）. The temperature recovery, cough disappeared, leukocyte recovery time of the observation group were （ 3.61 ± 0.61 ） d, （ 6.11 ± 0.81 ） d, （ 7.85 ± 0.92 ） d, which were significantly shorter than those of the control group, the differences were statistically significant （ t = 4. 145, P = 0.025 ; t = 4. 045, P = 0.027 ; t =4. 385,P =0.021 ）. The treatment of the two groups had mild liver and kidney damage,and there was no signifi- cant difference between the two groups（ all P 〉 0.05 ）. Conclusion Voriconazole treatment has good clinical effect for lung cancer patients after radiotherapy and chemotherapy with invasive fungal infections, the treatment period is short, but with mild liver and kidney function impairment, the treatment should strengthen the monitoring.