伊曲康唑治疗儿童急性白血病合并真菌感染的临床疗效及对血清炎症因子和凝血指标的影响

Effect of itraconazole in the treatment of fungal infection in pediatric acute leukemia and its impact on serum inflammatory factors and coagulation indicators

目的探讨伊曲康唑治疗儿童急性白血病合并真菌感染的临床疗效及对血清炎症因子和凝血指标的影响。方法采用随机数字表法将80例白血病合并真菌感染患儿分为观察组(n=40)和对照组(n=40),观察组给予伊曲康唑治疗,对照组给予伏立康唑治疗。比较两组患儿的临床疗效、发热持续时间、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平、凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和血管性假血友病因子(vWF)]以及不良反应发生率。结果观察组患儿的临床疗效优于对照组,差异有统计学意义(P <0.05)。观察组患儿的发热持续时间为(7.10±1.14)天,明显短于对照组的(11.30±1.21)天,差异有统计学意义(P <0.05)。治疗后,观察组患儿的CRP、PCT、TNF-a和IL-6水平均低于对照组,差异均有统计学意义(P <0.05)。治疗后,观察组患儿的PT、APTT均短于对照组,vWF低于对照组,差异均有统计学意义(P <0.05)。观察组和对照组患儿消化道反应、肝功能异常、肾功能异常、视觉异常的发生率比较,差异均无统计学意义(P> 0.05)。结论伊曲康唑治疗儿童急性白血病合并真菌感染具有较好的疗效,可降低炎症因子水平,恢复凝血功能。

Objective To investigate the effect of itraconazole in the treatment of fungal infection in pediatric acute leukemia and its impact on serum inflammatory factors and coagulation indicators.Method 80 children with fungal infection in pediatric acute leukemia were selected and divided into observation group(n=40)and control group(n=40)using a random number table.The observation group was treated with itraconazole and the control group was treated with voriconazole.The clinical efficacy,duration of fever,inflammatory factors C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]levels,coagulation indicators[prothrombin time(PT),activated partial thromboplastin time(APTT)and von Willebrand factor were measured and compared.Result The clinical efficacy of children in the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).The duration of fever in the observation group was(7.10±1.14)days,which was significantly shorter than(11.30±1.21)days of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CRP,PCT,TNF-αand IL-6 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the PT and APTT of the observation group were shorter than those of the control group,and the vWF was lower than that of the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of gastrointestinal adverse events,liver function abnormalities,renal function abnormalities,and visual abnormalities between the observation group and the control group(P>0.05).Conclusion Itraconazole has good curative effect in the treatment of pediatric acute leukemia complicated with fungal infection,which can reduce the level of inflammatory factors and restore blood coagulation function.