摘要
目的:探究在中性粒细胞缺乏伴发热患者中采用卡泊芬净联合伊曲康唑经验性治疗的临床效果。方法:选取2020年5月至2022年2月在阳江市人民医院进行血液系统肿瘤治疗期间出现中性粒细胞缺乏伴发热的120例患者,根据随机数字法分为对照组和观察组,各60例。对照组采用卡泊芬净治疗,观察组在对照组基础上联合伊曲康唑治疗。比较两组患者的临床疗效、临床相关指标、炎症因子水平、病原菌清除率、退热率及生存率、毒副作用情况。结果:观察组患者临床总有效率高于对照组,差异具有统计学意义(P <0.05)。观察组患者真菌病理转阴时间、退热时间、住院时间均短于对照组,差异具有统计学意义(P <0.05)。治疗后,观察组血清患者肿瘤坏死因子–α(TNF–α)、白细胞介素–6(IL–6)、C反应蛋白(CRP)、降钙素原(PCT)水平低于对照组,差异具有统计学意义(P <0.05)。观察组患者病原菌清除率、退热率及生存率均高于对照组,差异具有统计学意义(P <0.05)。观察组患者毒副作用总发生率低于对照组,差异具有统计学意义(P <0.05)。结论:中性粒细胞缺乏伴发热患者中采用卡泊芬净联合伊曲康唑经验性治疗有助于提高临床效果,降低炎症因子水平,提高患者的退热率、病原菌清除率和生存率,促进患者的康复,且安全性相对较高。
Objective To explore the clinical effect of the empirical treatment of carpofungin combined with itraconazole in patients with neutrophil deficiency and fever. Methods A total of 120 patients with neutrophilia deficiency and fever during hematologic tumor treatment in Yangjiang People's Hospital from May 2020 to February 2022 were selected and divided into a control group and an observation group according to random number method, with 60 cases in each group. The control group was treated with carpofungin, and the observation group was treated with itraconazole on the basis of the control group. The clinical efficacy, clinical indicators, levels of inflammatory factors, clearance rate of pathogenic bacteria, fever-reducing rate and survival rate, toxicity and side effects were compared between the two groups. Results The total clinical effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P < 0.05). The time of fungal pathological transition to negative, fever remission and hospital stay in the observation group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The pathogenic bacteria clearance rate, febrile regression rate and survival rate in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The total incidence of side effects in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion The empirical treatment of carpofungine combined with itraconazole in patients with neutrophil deficiency and fever is helpful to improve the clinical effect, reduce the level of inflammatory factors, improve the fever reduction rate, pathogen clearance rate and survival rate of patients, and promote the recovery of patients, with relatively high safety.
作者
司徒健瑜
张湘兰
徐伟峰
SITU Jianyu;ZHANG Xianglan;XU Weifeng(Yangjiang People's Hospital,Guangdong Yangjiang 529500)
出处
《深圳中西医结合杂志》
2023年第22期8-11,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
阳江市医疗卫生类科技计划项目(SF2020054)。
