伏立康唑治疗老年白血病合并侵袭性肺部真菌感染的临床效果

Clinical effect of voriconazole in the treatment of elderly leukemia complicated with invasive pulmonary fungal infection

目的探讨伏立康唑治疗老年白血病合并侵袭性肺部真菌感染的临床效果。方法选择2014年3月至2018年12月在我院住院治疗的68例老年白血病合并侵袭性肺部真菌感染患者作为研究对象,按照入院顺序将其分为对照组和观察组,各34例。对照组给予两性霉素B治疗,观察组给予伏立康唑治疗。比较两组临床疗效、不良反应发生情况、血清炎症因子水平及真菌感染清除率。结果观察组治疗总有效率为94.12%,高于对照组的76.47%,差异具有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-12水平均较治疗前降低,IL-10水平较治疗前升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率为11.76%,低于对照组的32.35%,差异具有统计学意义(P<0.05)。观察组真菌感染清除率为82.35%,高于对照组的67.65%,差异具有统计学意义(P<0.05)。结论伏立康唑和两性霉素B治疗老年白血病合并侵袭性肺部真菌感染患者均有效,且均可改善患者的血清炎症因子水平,但伏立康唑治疗效果更佳,使用更为安全。

Objective To investigate the clinical effect of voriconazole in the treatment of elderly leukemia complicated with invasive pulmonary fungal infection.Methods A total of 68 patients with elderly leukemia complicated with invasive pulmonary fungal infection treated in our hospital from March 2014 to December 2018 were selected as the research objects.According to the order of admission,the patients were divided into control group and observation group,with 34 cases in each group.The control group was treated with amphotericin B,and the observation group was treated with voriconazole.The clinical efficacy,occurrence of adverse reactions,the levels of serum inflammatory factors and clearance rate of fungal infection were compared between the two groups.Results The total effective rate of treatment in the observation group was 94.12%,which was higher than 76.47%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of TNF-αand IL-12 in the two groups were lower than those before treatment,and the level of IL-10 was higher than that before treatment,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 11.76%,which was lower than 32.35%in the control group,and the difference was statistically significant(P<0.05).The clearance rate of fungal infection in the observation group was 82.35%,which was higher than 67.65%in the control group,and the difference was statistically significant(P<0.05).Conclusion Voriconazole and amphotericin B in the treatment of elderly leukemia patients with invasive pulmonary fungal infection are effective,which can improve the serum inflammatory factor levels of patients,but voriconazole is more effective and safer.