作　　者： (张平）;

机构地区： 四川省绵阳市中医医院肾内科,四川绵阳621000

出　　处： 《医学临床研究》 2017年第8期1487-1488,1491,共3页

摘　　要： 【目的】探讨伏立康唑治疗慢性肾功能不全（CRF）合并肺部真菌感染（PFI）的疗效。【方法】依据入院顺序，将本院收治的82例CRF合并PFI患者分为两组，各41例，对照组给予氟康唑、观察组给予伏立康唑治疗，比较两组治疗后的临床疗效、生命体征[体温、脉搏、呼吸、收缩压、舒张压]、肾功能[血尿素氮（BuN）、内生肌酐清除率（Ccr）、24h尿蛋白定量]、药物安全性及治疗后1年随访复发率。【结果】治疗后观察组总有效率为87．80％（36／41）明显高于对照组68．29（28／41）、观察组不良反应总发生率、1年随访复发率明显低于对照组，且差异有显著性（P〈0．05）；治疗前两组生命体征相关指标、肾功能指标相比较无明显差异（P〉0．05）；治疗后两组体温，脉搏、呼吸、收缩压、舒张压均较治疗前明显减低，BUN、24h尿蛋白定量明显降低，Ccr明显升高（P〈0．05），且观察组各项指标较对照组改善明显（P〈0．05）。【结论】伏立康唑治疗CRF合并PFI患者临床疗效确切，安全性高且复发率低，值得推广应用。 [ObjectivelTo investigate the effect of voriconazole in the treatment of chronic renal insufficiency（CRF） with pulmonary fungal infection（PFI）.[Methods]A total of 82 CRF patients with PFI were divided into two groups , with 41 cases in each group. The control group and experimental group were each treated with fluconazole and voriconazole, re- spectively. The clinical efficacy, vital signs, renal function [blood urea nitrogen （BUN）, creatinine clearance rate （Ccr）, 24h urine protein quantitation-], drug safety and the recurrence rate after one year after treatment were observed in both groups.[ResultslAfter treatment, the total effective rate was 87.80% （36/41） in the experimental group, which was significantly higher than that in the control group 68.29% （28/41）. The incidence rate of adverse reactions and one-year recurrence rate in the experimental group were lower than those in the control group （ P〈0.05）.Before treatment, there were no significant differences in vital signs and renal function between the two groups （ P 〉 0.05）. After treatment, body temperature, pulse, respiration, systolic blood pressure, diastolic blood pressure, BUN, and 24h urinary protein quantitation were significantly decreased in both groups, while Ccr was significantly increased. However, the change in these indicators in the experimental group was more significant than that in the control group （ P 〈0.05）.[Conclusion] Voriconazole is more effective in the treatment of CRF with PFI and it shows a safer and lower recurrence rate as well. It is worthy of promotion in clinical application.

关 键 词： 氟康唑 治疗应用 抗真菌药 治疗应用 肾功能不全 慢性 并发症 肺疾病 真菌性 并发症 肺疾病 真菌性 药物疗法