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目的评价伊曲康唑治疗侵袭性真菌感染的有效性和安全性。方法选择2003年9月至2005年9月中国医科大学附属第一医院应用伊曲康唑完整疗程治疗的侵袭性真菌感染患者16例(17例次)。其中确诊1例,疑似11例(12例次),可能感染4例。患者用量第1天至第2天伊曲康唑注射液200mg,每天2次,静脉注射;第3天至第14天:200mg,每天1次,静脉注射;第15天至第42天改用伊曲康唑胶囊或口服液200mg,每天2次。2例患者应用200mg,每天2次,分别静脉注射治疗9d和14d;1例200mg,每天1次,静脉注射治疗21d。结果16例患者共检出真菌菌株62株,其中尿培养40株,热带念珠菌占首位21株。确诊和疑似的12例(13例次)患者中痊愈率6/13,有效率为11/13,真菌清除率6/13。入选22例(24例次)患者中,不良反应发生率3/24。结论伊曲康唑治疗深部真菌感染有效,尤其在危重、高龄患者中长时间应用安全性高。
Objective To evaluate the efficacy and safety of itraconazole in the treatment of invasive fungal infections. Methods From September 2003 to September 2005, the First Affiliated Hospital of China Medical University, the complete course of itraconazole treatment of invasive fungal infections in 16 patients (17 cases). Among them, 1 was diagnosed, 11 were suspected (12 cases) and 4 were likely to be infected. Patients Day 1 to Day 2 Itraconazole Injection 200mg twice a day, intravenously; Day 3 to Day 14: 200mg, once daily, intravenously; Day 15 to Day 42 Switching to Itraconazole capsules or oral solution 200mg, 2 times a day. Two patients were treated with 200mg twice a day for 9d and 14d after intravenous injection. One patient received 200mg once daily for 21 days. Results A total of 62 fungal strains were detected in 16 patients, of which 40 were urine culture and 21 were Candida tropicalis. Among the 12 diagnosed and suspected cases (13 cases), the cure rate was 6/13, the effective rate was 11/13 and the fungal clearance rate was 6/13. In 22 cases (24 cases), the incidence of adverse reactions was 3/24. Conclusion Itraconazole is effective in the treatment of deep fungal infections, especially in the elderly patients with long-term safety.