摘要
目的 分析伏立康唑与伊曲康唑在慢性肺曲霉菌病(chronic pulmonary aspergillosis, CPA)患者中的应用效果。方法 选择200例CPA患者,按照用药方案不同分为伏立康唑组(n=100)和伊曲康唑组(n=100)。观察2组的临床疗效、症状缓解情况、病原菌检测结果、肺功能指标[第一秒用力呼气容积(forced expiratory volume in one second, FEV1)、肺活量(forced vital capacity, FVC)和FEV1/FVC]变化、炎症反应水平[C反应蛋白(C-reactive protein, CRP)、降钙素原(procalcitonin, PCT)和肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)]以及药物不良反应的发生情况。结果 伏立康唑组治疗总有效率高于伊曲康唑组(P<0.05);伏立康唑组患者发热、咯血、咳嗽、咳痰和呼吸困难持续时间均短于伊曲康唑组(P<0.05);伏立康唑组治疗后血清半乳甘露聚糖抗原检测阳性率低于伊曲康唑组(P<0.05);治疗3个月后,伏立康唑组FEV1、FVC和FEV1/FVC高于伊曲康唑组(P<0.05);伏立康唑组CRP、PCT和TNF-α水平低于伊曲康唑组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 伏立康唑治疗CPA患者疗效较伊曲康唑更为显著,该药物对患者临床症状、炎症反应的缓解以及肺功能的改善均起到积极作用,且服药后未增加不良反应的发生,安全性较好。
Objective To analyze the application effect of voriconazole and itraconazole in patients with chronic pulmonary aspergillosis(CPA).Methods A total of 200 patients with CPA were enrolled. According to different treatment regimens, they were divided into voriconazole group(n=100) and itraconazole group(n=100). The clinical curative effect, symptoms relief, detection results of pathogens, changes of lung function indexes [forced expiratory volume in 1 second(FEV1), forced vital volume(FVC), FEV1/FVC], level of inflammatory response [C-reactive protein(CRP), procalcitonin(PCT), tumor necrosis factor-α(TNF-α)] and the occurrence of adverse drug reactions in both groups were observed.Results The total response rate of treatment in voriconazole group was higher than that in itraconazole group(P<0.05). The duration of fever, hemoptysis, cough, expectoration and dyspnea in voriconazole group was shorter than that in itraconazole group(P<0.05). After treatment, the positive rate of serum galactomannan antigen in voriconazole group was lower than that in itraconazole group(P<0.05). After 3 months of treatment, FEV1, FVC and FEV1/FVC in voriconazole group were higher than those in itraconazole group(P<0.05), while the levels of CRP, PCT and TNF-α were lower than those in itraconazole group(P<0.05). The difference in the incidence of adverse reactions between the 2 groups was not statistically significant(P>0.05).Conclusion Compared with itraconazole, the curative effect of voriconazole is more significant in CPA patients, which plays positive roles in alleviating clinical symptoms and inflammatory response and improving lung function, and will not increase the adverse reactions after medication, with high safety.
作者
李瑞芳
孔旭东
刘建平
LI Ruifang;KONG Xudong;LIU Jianping(Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100020,China;Department of Pharmacy,Handan Hospital of Traditional Chinese Medicine,Handan 056001,China)
出处
《西北药学杂志》
CAS
2023年第2期185-189,共5页
Northwest Pharmaceutical Journal
基金
河北省中医药管理局2021年度中医药类科研计划项目(编号:2021467)。
关键词
伏立康唑
伊曲康唑
慢性肺曲霉菌病
肺功能
炎症反应
voriconazole
itraconazole
chronic pulmonary aspergillosis
lung function
inflammatory response
