小剂量氟康唑治疗慢性阻塞性肺疾病继发肺部真菌感染的回顾性分析

目的 探究对慢性阻塞性肺疾病（COPD）继发肺部真菌感染患者应用小剂量氟康唑的临床疗效分析。方法 选取2016年2月-2018年2月信阳市中心医院收治的COPD继发肺部感染患者共58例作为研究对象,随机分为观察组（29例）和对照组（29例）。对照组患者应用广谱抗菌药物及解痉平喘、雾化吸入糖皮质激素等治疗;观察组在对照组基础上应用小剂量氟康唑胶囊,100 mg/次,1次/d。两组治疗时间为2周。观察比较两组患者治疗效果,真菌清除情况及不良反应发生率。结果 治疗后,观察组总有效率为93.10%,显著高于对照组的68.97%,差异具有统计学意义（P<0.05）。治疗后,观察组和对照组患者真菌清除率分别为96.55%和62.07%,观察组真菌清除率明显高于对照组,且差异具有统计学意义（P<0.05）。观察组中出现1例胃肠道反应,而对照组中出现1例肝功能损害,1例皮疹,两组患者的不良反应发生情况无显著差异。结论 小剂量氟康唑对COPD继发肺部真菌感染疗效显著,不良反应较少,建议临床推广应用。

A retrospective analysis of of low dose fluconazole in treatment of chronic obstructive pulmonary disease with pulmonary fungal infection

Objective To investigate the clinical efficacy of low-dose fluconazole in treatment of pulmonary fungal infection secondary to COPD. Methods A total of 58 cases of pulmonary fungal infection secondary to COPD were selected from February 2016 to February 2018 in Xinyang Central Hospital. All the patients were divided into observation (29 cases) and control (29 cases) groups. The control group were given broad-spectrum antibiotics, spasmodic antiasthmatic, atomizing inhaled corticosteroids, etc. The observation group was treated with low dose Fluconazole Capsules on the basis of the control group, 100 mg/time, once daily. Patients were treated for 2 weeks. The therapeutic effect was observed, and the fungal clearance and incidence of adverse reactions in two groups were compared. Results After treatment, the total effective rate was 93.10%, significantly higher than 68.97% of control group, and the difference was statistically significant (P<0.05). After treatment, the fungal clearance rate of the observation group was 96.55% while in the control group was 62.07%. The fungal clearance rate of the observation group was significantly higher than that of the control group, and the difference was significant (P<0.05). There was 1 case of gastrointestinal reaction in the observation group, 1 case of liver function damage and 1 case of rash in the control group. There was no significant difference in adverse reactions between the two groups. Conclusion Low dose fluconazole has significant curative effect on pulmonary fungal infections secondary to COPD with fewer adverse reactions, which is recommended to promote clinical application.