两种治疗方法对肺结核合并侵袭性肺曲霉菌病的疗效观察

目的 评估两种治疗方法对肺结核合并侵袭性肺曲霉菌病的疗效.方法 将41例肺结核合并侵袭性肺曲霉菌病的患者随机分成两组,其中A组24例,应用两性霉素B脂质体与伊曲康唑序贯治疗:首先应用两性霉素B脂质体注射液静脉滴注,1次/d,疗程2周,后改用伊曲康唑胶囊口服,每次0.2 g,2次/d,疗程10周;B组17例,先应用两性霉素B脂质体注射液静脉滴注,用法同A组,后改用伏立康唑片口服,0.2 g/次,2次/d,疗程10周;两组总疗程均为12周;分别对两组的疗效进行统计分析.结果 B组治疗有效率为64.7％,A组治疗有效率为33.3％,两组间差异有统计学意义(P＜0.05).结论 应用两性霉素B脂质体与伏立康唑序贯治疗肺结核合并侵袭性肺曲霉菌病的疗效较好.

Efficacy of two methods of treatment of pulmonary tuberculosis with invasive pulmonary aspergillosis

OBJECTIVE To evaluate the effects of two treatment methods for pulmonary tuberculosis combined invasive pulmonary aspergillosis.METHODS A total of 41 pulmonary tuberculosis patients combined with invasive pulmonary aspergillosis were randomly divided into 2 groups,the group A with 24 cases received the sequential therapy of liposomal amphotericin B and itraconazole,the first application was liposomal amphotericin B intravenous injection with once daily for 2 weeks and then switched to oral itraconazole capsules,each 0.2g,twice daily course of 10 weeks;the group B with 17 cases received sequential therapy of liposomal amphotericin B and voriconazole,the first application was liposomal amphotericin B intravenous injection,the specific use was as same as the A group and then switched to oral voriconazole tablets,each 0.2g,twice daily treatment for 10 weeks;the total course of treatment groups was 12 weeks;the efficacy of the two groups was statistically analyzed.RESULTS The effective rate of group B was 64.7%,the effective rate of the group A was 33.3%,the difference was statistically significant(P<0.05).CONCLUSION The application of liposomal amphotericin B and itraconazole for the sequential therapy of pulmonary tuberculosis combined with invasive pulmonary aspergillosis is effective.