伊曲康唑联合糖皮质激素治疗变态反应性支气管肺曲霉菌病的疗效分析

目的 评价伊曲康唑联合糖皮质激素治疗变态反应性支气管肺曲霉菌病（ABPA）的疗效.方法 回顾性收集11例ABPA患者接受伊曲康唑联合糖皮质激素治疗前和治疗2个月后的临床特征和指标,通过比较治疗前后临床特征和指标的变化评价治疗效果.结果 所有患者的症状和体征明显改善.治疗2个月后,C反应蛋白由（42±13） mg/L降至（7±2）mg/L,IgE水平由（1685±477） kU/L降至（742±236） kU/L,嗜酸性粒细胞计数由（1 925±318）×10/L降至（343±112）×106/L,第1秒用力呼气容积占预计值百分比由（32.4±9.1）％升至（77.5±8.6）％,动脉血氧分压由（53±6）mmHg（l mmHg=0.133 kPa）升至（81±12） mmHg,差异均有统计学意义（P＜ 0.01或＜0.05）.肺CT显示肺内炎性渗出消散明显.结论 伊曲康唑联合糖皮质激素可有效治疗ABPA.

Clinical efficacy of itraconazole combined with glucocorticosteroid in allergic bronchopulmonary aspergillosis

Objective To evaluate the efficacy of itraconazole combined with glucocorticosteroid in allergic bronchopulmonary aspergillosis.Methods The clinical characteristics and data of 11 allergic bronchopulmonary aspergillosis patients treated with itraconazole combined with glucocorticosteroid were retrospectively collected before treatment and two months after treatment.Then the clinical characteristics and data before and after treatment were compared to evaluate the efficacy of the treatment.Results The symptoms and signs got better after two months＇ treatment.C reactive protein,IgE and eosinophile granulocyte count after two months＇ treatment were significantly lower than that before treatment [（7 ±2） mg/L vs.（42± 13） mg/L,（742 ± 236） kU/L vs.（1 685 ±477） kU/L,（343 ± 112） × 106/L vs.（1 925 ± 318） × 106/L],and forced expired volume in one second percentage of predicted and arterial partial pressure of oxygen after two months＇ treatment were significantly higher than those before treatment [（77.5 ± 8.6）％ vs.（32.4 ± 9.1）％ and （81 ± 12） mmHg （1 mmHg =0.133 kPa） vs.（53 ± 6） mmHg],there were statistical differences （P ＜ 0.01 or ＜ 0.05）.The inflammatory exudates resolved as demonstrated in pulmonary CT scan.Conclnsion Itraconazole combined with glucocorticosteroid can effectively neat allergic bronchopulmonary aspergillosis.