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目的评价伊曲康唑注射液治疗侵袭性肺部真菌感染(IPFI)的疗效。方法收集广东省人民医院呼吸科2006年使用伊曲康唑注射液治疗侵袭性肺部真菌感染患者17例,对其疗效进行分析研究。PFI诊断根据“IPFI的诊断标准与治疗原则(草案)”,确诊病例9例,临床诊断5例,拟诊病例3例。结果17例患者中共培养出真菌14株,包括白色念珠菌5株,曲霉菌6株,未分类真菌3株。在接受治疗的17例患者中,痊愈9例,显效2例,进步3例,无效(死亡)3例,总有效率为64.7%。12例接受氟康唑针剂治疗后改为伊曲康唑者9例有效,3例死亡。死亡的3例中2例为肾移植术后感染,1例为糖尿病酮症酸中毒的患者。在治疗过程中仅3例患者有轻微恶心、呕吐,未观察到严重的副反应。结论伊曲康唑注射液是治疗侵袭性肺部真菌感染有效的药物,临床上可作为一线用药治疗使用。
Objective To evaluate the efficacy of itraconazole injection in the treatment of invasive pulmonary fungal infection (IPFI). Methods A total of 17 patients with invasive pulmonary fungal infection treated with itraconazole injection in Department of Respiratory Medicine, People’s Hospital of Guangdong Province in 2006 were collected and analyzed. PFI diagnosis According to “IPFI diagnostic criteria and principles of treatment (Draft)”, confirmed cases in 9 cases, 5 cases of clinical diagnosis, the proposed case of 3 cases. Results A total of 14 fungi were cultured in 17 patients, including 5 Candida albicans, 6 Aspergillus and 3 unclassified fungi. Among the 17 patients treated, 9 were cured, 2 were markedly improved, 3 were improved, 3 were ineffective (death), and the total effective rate was 64.7%. Of the 12 patients who received fluconazole after treatment with itraconazole, 9 were effective and 3 died. Two of the three deaths were post-renal transplant infections and one was diabetic ketoacidosis. Only 3 patients had slight nausea and vomiting during treatment, and no serious side effects were observed. Conclusion Itraconazole injection is an effective drug for the treatment of invasive pulmonary fungal infection and can be used clinically as first-line therapy.