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目的比较研究不同时机应用两性霉素B脂质体治疗慢性阻塞性肺疾病(COPD)合并肺部侵袭性真菌感染(IFI)患者的临床效果,探讨不同时机应用两性霉素B脂质体在治疗COPD合并IFI中的应用价值。方法回顾性分析2010年1月-2013年1月COPD合并IFI的102例患者使用两性霉素B脂质体治疗的临床资料,比较分析两性霉素B脂质体在经验治疗(拟诊及临床诊断患者62例)及目标治疗(微生物确诊患者40例)COPD合并IFI中的应用价值,分析治疗过程中两组患者的肝肾功能、电解质及体温等的变化,采用SPSS15.0软件进行统计分析。结果目标治疗有效率为45.00%,低于经验治疗的77.42%;经验治疗的平均疗程为(14.02±4.45)d,比目标治疗的(21.88±5.21)d短;经验治疗的不良反应率为38.71%,低于目标治疗的62.50%,差异均有统计学意义(P<0.05)。结论两性霉素B脂质体可有效治疗COPD合并IFI,经验治疗与目标治疗相比能提高治疗效果,并且减少不良反应的发生率。
Objective To compare the clinical effects of amphotericin B liposomes on patients with chronic obstructive pulmonary disease (COPD) and pulmonary invasive fungal infection (IFI) at different time points and to explore the effect of amphotericin B liposomes The Value of COPD in IFI. Methods The clinical data of 102 patients with COPD and IFI treated with amphotericin B liposomes from January 2010 to January 2013 were retrospectively analyzed. The clinical data of amphotericin B liposomes were compared between the two groups 62 patients were diagnosed) and target therapy (40 patients diagnosed by microbiology) in patients with COPD and IFI. The changes of liver and kidney function, electrolytes and body temperature in both groups during the treatment were analyzed and analyzed by SPSS15.0 software . Results The target effective rate was 45.00%, which was lower than 77.42% of the experienced patients. The average duration of the experience-based treatment was (14.02 ± 4.45) days, shorter than the target (21.88 ± 5.21) d. The rate of adverse reactions was 38.71 %, Lower than the target treatment of 62.50%, the difference was statistically significant (P <0.05). Conclusion Amphotericin B liposomes are effective in treating COPD complicated with IFI. Compared with the target therapy, empirical therapy can improve the therapeutic effect and reduce the incidence of adverse reactions.