| 伊曲康唑与氟康唑在重症监护室早期经验性治疗真菌感染的疗效比较 |
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| 引用本文： | 黄磊,张赤,陈映群. 伊曲康唑与氟康唑在重症监护室早期经验性治疗真菌感染的疗效比较[J]. 医药导报, 2006, 25(11): 1155-1157 |
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| 作者姓名： | 黄磊 张赤 陈映群 |
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| 作者单位： | 北京大学深圳医院重症监护室,518036 |
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| 摘 要： | 目的比较伊曲康唑和氟康唑在重症监护室早期经验性治疗中的有效性和安全性。方法采取随机、对照、开放的临床试验，入选的40例患者具有真菌感染的高危因素，均出现不明原因发热，广谱抗生素治疗3～7 d无效。将入选患者随机分配为伊曲康唑治疗组和氟康唑治疗组各20例。伊曲康唑治疗组给予伊曲康唑注射液200 mg，q12 h，先治疗2 d，随后给予200 mg，qd，共5 d，再改用伊曲康唑口服液口服，每次200 mg，bid，治疗14 d；氟康唑治疗组给予氟康唑注射液400 mg静脉滴注，qd，共治疗21 d。观察患者体温变化、真菌感染情况、药物相关的不良反应和疗效。结果伊曲康唑组总有效率65.0%，不良反应率30.0%；氟康唑组总有效率50.0%，不良反应率5.0%，但两组总有效率和不良反应发生率均差异无显著性（均P＞0.05）。治疗过程中，氟康唑组出现2例深部真菌感染。结论伊曲康唑和氟康唑均可作为现阶段重症监护室早期经验性治疗的一线药物，但伊曲康唑疗效更佳。
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| 关 键 词： | 伊曲康唑 氟康唑 早期经验性治疗 真菌感染；ICU |
| 文章编号： | 1004-0781（2006）11-1155-03 |
| 收稿时间： | 2005-10-21 |
| 修稿时间： | 2005-11-20 |
It raconazole Versus Fluconazole as Earlier Empirical Antifungal Therapy in ICU |
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| HUANG Lei,ZHANG Chi,CHEN Ying-qun. It raconazole Versus Fluconazole as Earlier Empirical Antifungal Therapy in ICU[J]. Herald of Medicine, 2006, 25(11): 1155-1157 |
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| Authors: | HUANG Lei ZHANG Chi CHEN Ying-qun |
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| Affiliation: | Intensive Care Units Shenzhen Hospital, Peking University, Shenzhen 518036, China |
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| Abstract: | Objective To compare the efficacy and safety of itraconazole with those of fluconazole as earlier empirical antifungal therapy in ICU. Methods In a randomized,controlled,open trial,40 patients with risk factors of systemic fungal infections and unexplained fever that did not respond to broad-spectrum antibiotic therapy for 3-7 days were randomly divided into itraconazole group(20 patients) and fluconazole group(20 patients).Intravenous itraconazole,200 mg,was administered by infusion every 12 hours for the first 48 hours,followed by 200 mg daily from days 3 to 7.From day 8,oral itraconazole solution,200 mg twice daily,replaced intravenous itraconazole for another 14 days.Fluconazole was infused intravenously at a daily dose of 400 mg for 21 days.Body temperature,fungal infection,drug-related adverse events,and the efficacy were investigated. Results For itraconazole and fluconazole,the overall effective rates were 65.0% and 50.0%,and the adverse reactions rates were 30.0% and 5.0% respectively.But there were no significant differences in the overall effective rates and the adverse reactions rates between two groups.Two patients developed deep fungal infections in fluconazole group during the therapy. Conclusion Nowadays,itraconazole and fluconazole are effective and safe as the first-line drugs in earlier empirical therapy in ICU.However,itraconazole appears better in efficacy. |
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| Keywords: | ICU |
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