摘要
目的探索肝衰竭并发肺部真菌感染患者病原菌分布情况,对比伊曲康唑、伏立康唑治疗肝衰竭并发肺部真菌感染患者的效果以及对免疫功能的影响性。方法回顾性分析的116例肝衰竭并发肺部真菌感染患者均在2018年4月至2020年8月期间收治,分析患者病原菌分布情况,再根据治疗方法分为两组,对照组57例进行伊曲康唑治疗,观察组59例进行伏立康唑治疗,并对比各时间段患者的免疫功能、疾病缓解率、肝功能等指标。结果116例肝衰竭并发肺部真菌感染患者,以新生隐球菌感染最为常见,所占比为49.14%,其次为曲霉菌、毛霉菌,所占比分别为27.59%、18.96%,白假丝酵母最罕见,所占比为4.31%。两组比较治疗后各时间段水平无统计学差异性(P>0.05),观察组治疗后4周CD3^(+)(60.46±2.65)%、治疗后4周CD4^(+)(34.46±2.65)%、治疗后8周CD3^(+)(62.41±2.43)%、治疗后8周CD4^(+)(36.86±2.65)%高于对照组,治疗后4周CD8^(+)(20.13±2.36)%、治疗后8周CD8^(+)(19.12±2.33)%低于对照组。同时观察组治疗后4周疾病缓解率59.32%、治疗后6周疾病缓解率74.58%、治疗后8周的疾病缓解率81.36%高于对照组(P<0.05)。结论肝衰竭并发肺部真菌感染患者以新生隐球菌感染病原菌最为常见,接受伏立康唑治疗后,不会对肝脏产生较大影响,还可改善免疫功能,提高疾病缓解率。
Objective To explore the distribution of pathogenic bacteria in patients with liver failure complicated with pulmonary fungal infection,and to compare the treatment effects of itraconazole and voriconazole in these patients,and their influence on immune function.Methods One hundred and sixteen patients with liver failure complicated with pulmonary fungal infection that were admitted between April 2018 and August 2020 were enrolled in this study.They were retrospectively analyzed on the distribution of pathogenic bacteria that they affected.The patients were divided into 2 groups according to the treatment method.57 cases in the control group were treated with itraconazole,while 59 patients in the observation group were treated with voriconazole.The immune function,disease remission rate,and liver function were compared between these two groups of patients at different time points post treatment.Results In 116 patients with liver failure and pulmonary fungal infection,Cryptococcus neoformans infection was the most common,accounting for 49.14%of the patients,followed by Aspergillus and Mucor,accounting for 27.59%and 18.96%.Candida albicans was the most rare pathogen,accounting for 4.31%of the patients.There was no statistical difference between these two groups of patients at different time points post treatment(P>0.05).The observation group had CD3^(+)(60.46±2.65)%,CD4^(+)(34.46±2.65)%at 4 weeks after treatment,and CD3^(+)(62.41±2.43)%,CD4^(+)(3,6.86±2.65)%at 8 weeks after treatment,which were higher than those of the control group.On the contrary,the CD8^(+)(20.13±2.36)%at 4 weeks,and CD8^(+)(19.12±2.33)%at 8 weeks after treatment were lower than those of the control group.Meanwhile,the disease remission rate of the observation group was 59.32%at 4 weeks after treatment,74.58%at 6 weeks after treatment,and 81.36%disease remission rate at 8 weeks after treatment,all were higher than those of the control group(P<0.05).Conclusion In patients with liver failure and pulmonary fungal infection,Cryptococcus neoformans infection is the most common pathogen.Voriconazole treatment has no major impact on the liver.It can improve the immune function and increase the disease remission rate.
作者
袁震
杨海平
马晓艳
袁芳菊
YUAN Zhen;YANG Hai-ping;MA Xiao-yan;YUAN Fang-ju(Department of Respiratory Medicine,The Fifth People's Hospital of Qinghai Province,Xining 810000,China;Qinghai Provincial Blood Center,Xining 810000,China)
出处
《肝脏》
2021年第12期1374-1377,1386,共5页
Chinese Hepatology
关键词
肝衰竭
肺部
真菌感染
病原菌
伏立康唑
免疫功能
Liver failure
Lung
Fungal infection
Pathogenic bacteria
Voriconazole
Immune function
