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张 聪1 戴钱姣2 朱潇冉1 潘颖璐1 戴霞红3▲.伏立康唑与卡泊芬净治疗肝衰竭并发侵袭性肺感染的效果比较[J].中国现代医生,2021,59(14):115-118
伏立康唑与卡泊芬净治疗肝衰竭并发侵袭性肺感染的效果比较
Comparison of efficacy of voriconazole and caspofungin in treatment of invasive lung infection complicated by liver failure
  
DOI:
中文关键词:  肝衰竭  侵袭性肺感染  伏立康唑  卡泊芬净  安全性
英文关键词:Liver failure  Invasive lung infection  Voriconazole  Caspofungin  Safety
基金项目:浙江省基础公益研究计划项目(LGF21H030012)
作者单位
张 聪1 戴钱姣2 朱潇冉1 潘颖璐1 戴霞红3▲ 1.浙江树人大学树兰国际医学院附属树兰杭州医院药学部浙江杭州 3100002.浙江大学医学院附属第一医院肝胆外科浙江杭州 3100003.浙江树人大学树兰国际医学院附属树兰杭州医院感染科浙江杭州 310000 
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中文摘要:
      目的 探讨伏立康唑与卡泊芬净治疗肝衰竭并发侵袭性肺感染的效果。方法 收集我院2016 年1 月至2020 年6 月使用伏立康唑与卡泊芬净治疗的78 例ACLF 并发IPA 患者作为研究对象。29 例伏立康唑治疗者纳入伏立康唑组,49 例卡泊芬净治疗者纳入卡泊芬净组。比较两组患者治疗前后肝功能指标与血清炎症因子水平变化情况、治疗效果、转归情况以及药物不良反应。结果 伏立康唑组治疗后INR 为(1.39±0.13),低于卡泊芬净组的(1.48±0.05),两组比较,差异有统计学意义(P<0.05);伏立康唑组治疗后血清白细胞计数(WBC)、降钙素原(PCT)、C 反应蛋白(CRP)水平分别为(10.58±1.82)×109/L、(1.49±0.41)ng/dL、(34.88±6.44)mg/L,与卡泊芬净组的(9.74±1.11)×109/L、(1.31±0.33)ng/dL、(35.33±6.37)mg/L 比较,差异无统计学意义(P>0.05);伏立康唑组好转率、随访4 周存活率、随访6 个月存活率分别为89.66%、68.97%、58.62%,与卡泊芬净组的85.71%、67.35%、57.14%比较,差异无统计学意义(P>0.05)。结论 伏立康唑与卡泊芬净治疗ACLF 并发IPA 均有良好的效果,无明显副作用。
英文摘要:
      Objective To explore the efficacy of voriconazole and caspofungin in the treatment of invasive lung infection complicated by liver failure.Methods A total of 78 patients with ACLF complicated with IPA who were treated with voriconazole and caspofungin in our hospital from January 2016 to June 2020 were collected as the research subjects.A total of 29 patients treated with voriconazole were included in the voriconazole group,and 49 patients treated with caspofungin were included in the caspofungin group.The changes of liver function indexes and serum inflammatory factors,treatment effects,outcomes and adverse drug reactions were compared between the two groups before and after treatment.Results After treatment,the INR of the voriconazole group was (1.39±0.13),which was lower than that of the caspofungin group (1.48±0.05),and the difference between the two groups was statistically significant (P<0.05).After treatment,the levels of white blood cell (WBC),proealcitonin (PCT) and C-reactive protein (CRP) were (10.58±1.82) ×109/L,(1.49±0.41) ng/dL,and (34.88±6.44) mg/L in the voriconazole group,which were compared with (9.74±1.11)×109/L,(1.31±0.33) ng/dL,(35.33±6.37) mg/L in the caspofungin group,and no differences were statistically significant(P>0.05).The improvement rate,and the survival rates after 4 weeks and 6 months follow-up were 89.66%,68.97% and 58.62%respectively in the voriconazole group,and no statistical significances were observed when those were compared with 85.71%,67.35% and 57.14% in the caspofungin group (P>0.05).Conclusion Both voriconazole and caspofungin show good efficacy in the treatment of ACLF complicated with IPA,without obvious side effects.
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