伏立康唑注射液静脉滴注联合碳酸氢钠气道内泵注及漱口治疗真菌性肺炎患者的疗效观察

Efficacy of intravenous drip of Voriconazole Injection combined with endobronchial pumping and rinsing mouth with sodium bicarbonate for treating patients with fungal pneumonia

目的探讨伏立康唑注射液静脉滴注联合碳酸氢钠气道内泵注及漱口治疗真菌性肺炎患者的临床效果。方法将80例真菌性肺炎患者随机分为伏立康唑注射液组和联合组,各40例。伏立康唑注射液组患者给予伏立康唑注射液静脉滴注治疗,联合组在此基础上加用碳酸氢钠溶液气道内泵注及漱口,均连续治疗14 d。比较两组患者治疗前后的肺功能相关指标、血清(1,3)-β-D葡聚糖、白细胞介素(IL)-13、IL-8、白细胞计数水平,以及两组患者咳嗽消失时间、啰音消失时间、体温恢复时间、痰菌转阴时间、治疗有效率、真菌清除率、不良反应发生率。结果治疗后,联合组患者的肺总量、用力肺活量、最大中期呼气流速、25%呼气峰值流速水平高于伏立康唑注射液组,血清(1,3)-β-D葡聚糖、IL-13、IL-8、白细胞计数水平低于伏立康唑注射液组,咳嗽消失时间、啰音消失时间、体温恢复时间、痰菌转阴时间短于伏立康唑注射液组,真菌清除率高于伏立康唑注射液组(均P<0.05)。两组患者的治疗有效率和不良反应发生率差异均无统计学意义(均P>0.05)。结论伏立康唑注射液静脉滴注联合碳酸氢钠气道内泵注及漱口治疗真菌性肺炎患者的疗效显著,可改善患者肺功能和临床症状,抑制炎症反应,提高真菌清除率,且安全性高。

Objective To investigate the clinical effect of intravenous drip of Voriconazole Injection combined with endobronchial pumping and rinsing mouth with sodium bicarbonate in the treatment of patients with fungal pneumonia.Methods Eighty patients with fungal pneumonia were randomly divided into Voriconazole Injection group and combination group,with 40 cases in each group.Patients in the Voriconazole Injection group were treated with intravenous drip of Voriconazole Injection,based on which the combination group received additional endobronchial pumping and rinsing mouth with sodium bicarbonate solution,the treatment lasted for 14 days in both groups.Lung function related indexes,serum(1,3)-β-D glucan,interleukin(IL)-13,IL-8,and WBC count levels were compared between the two groups before and after treatment,and cough disappearance time,rales disappearance time,body temperature recovery time,sputum negative conversion time,treatment efficiency,fungal clearance rate,and incidence rate of adverse reactions were compared between the two groups as well.Results After treatment,the combination group exhibited higher total lung capacity,forced vital capacity,maximum mid expiratory flow rate and 25%of peak expiratory flow rate,lower levels of serum(1,3)-β-D-glucan,IL-13,IL-8 and WBC count,shorter cough disappearance time,rales disappearance time,body temperature normalization time and sputum negative conversion time,and higher fungal clearance rate as compared with the Voriconazole Injection group(all P<0.05).There was no statistically significant difference between the two groups in treatment efficiency or incidence rate of adverse reactions(all P>0.05).Conclusion Intravenous drip of Voriconazole Injection combined with endobronchial pumping and rinsing mouth with sodium bicarbonate has a significant efficacy for the treatment of patients with fungal pneumonia,which can improve lung function and clinical symptoms of the patients,inhibit inflammatory reaction and increase fungal clearance rate with a high safety.