醋酸卡泊芬净与两性霉素B治疗高龄老人肺部真菌感染的临床对照研究

目的比较醋酸卡泊芬净与两性霉素B治疗高龄老人肺部真菌感染的疗效和毒副作用。方法入选136例患有肺部真菌感染高龄老人，63例患者应用醋酸卡泊芬净，73例应用两性霉素B，两组治疗时间均持续至体温正常后5d或连续痰涂片阴性后3d，或者疗程达14d。观察并评价两种药物的疗效和毒副作用。结果醋酸卡泊芬净和两性霉素B治疗高龄老人肺部真菌感染的总有效率分别为77．8％和60．2％，两者之间具有显著性差异（P〈0．05）。且醋酸卡泊芬净组较两性霉素B组的毒副作用更少，包括肾毒性、静脉炎、低钾、贫血及输液反应等。结论在治疗高龄老人的肺部真菌感染方面，醋酸卡泊芬净较两性霉素B有更好的疗效，并且毒副作用更轻。

Clinical Controlled Study on Caspofungin and Amphotericin B in Elderly Patients with Pulmonary Fungal Infections

Aim To compare the efficacy and safety of Caspofungin with those of amphotericin B in antifungal therapy in aged patients with pulmonary fungal infection.Methods Aged patients with pulmonary fungal infections who were treated with caspofungin(sixty-three cases) and amphotericin B(seventy-three cases) were observed respectively.Both treatments continued until five days after temperature returned normal or three days after negative in spear checks or treated for 14 days.The adverse events and the efficacy were investigated and evaluated.Results The overall effective rate of the Caspofungin group and amphotercin B group was 77.8% and 60.2%.There was statistical significance between the two groups(P<0.05).Adverse reactions,Such as development of nephrotoxicity,phlebitis,hypokalaemia,anemia and fever occurred significantly less often with Caspofungin than with amphotericin B.Conclusions Caspofungin was associated with better clinical outcomes(higher cure and fewer adverse effects) than amphotericin B in the treatment of elderly patients with pulmonary fungal infections.