卡泊芬净在心脏体外循环术后侵袭性真菌感染的临床应用.doc

卡泊芬净在心脏体外循环术后侵袭性真菌感染的临床应用 黄德荣,刘达兴B或氟康唑治疗（对照组），2010年以后14例用卡泊芬净治疗（观察组），治疗开始1周和2周后分别检测肝肾功能指标，肝功能（AST ，ALT，TBIL)，肾功能（BUN ，Scr）。疗程结束7-14d后随访观察治疗效果。结果：治疗1—2周观察组患者肝功能与对照组比较：1周后，AST（t=8.03，P＝0.00183）ALT（t=9.09，P＝0.00535）TBIL（t=6.01，P＝0.00382）；２周后AST（t=5.59，P＝0.00123）ALT（t=6.60，P＝0.00415）TBIL（t=8.45，P﹤0.00626）。治疗1周和2周后观察组患者肾功能与对照组比较：1周后，BUN（t=6.51，P＝0.00212）Scr（t=5.66，P＝0.00363）；２周后，BUN（t=7.61，P＝0.00635）Scr（t=6.91，P＝0.00556）。疗程结束7-14d后随访，对照组临床治愈率（4/13，69.2%），观察组的临床治愈率（12/14，85.7%）（P＝0.035）。结论：卡泊芬净是一种治疗心脏体外循环术后侵袭性真菌感染的理想药物。 【关键词】卡泊芬净；侵袭性真菌感染；心脏体外循环手术 Caspofungin in the treatment of invasive fungous infection after cardiac extracorporeal circulation surgery Huang Derong, Li Xiumao,Liu Daxing Department of Cardiovascular Surgery,the Affiliated hospital of zunyi medical college,Zunyi,Guizhou,563100,China Corresponding author: Liu Daxing Email:hdr110828@163.com 【Abstract】 Objective:To evaluate the efficacy and safety of Caspofungin for treatment of invasive fungous infection(IFI) in post cardiac extracorporeal circulation surgery patients. Methods: Clinical data of 27 cases of cardiac extracorporeal _________________ 作者单位: 563100贵州遵义 遵义医学院附属医院胸心血管外科 联系电话通信作者:刘达兴163.com circulation surgery patients with fungal infections were reviewed retrospectively ,in13 cases fungal infections were treated with amphotericin B or Fluconazole, after 2006,the infecion was treated with Caspofungin(observation group)in 14cases. liver function (AST, ALT, TBIL),and renal function (BUN, Scr).were evaluated at one and two weeks espectively.Result of treatment was evaluated 7-14d after the treatment as for the clinical cure rate. Ressults: The liver function of the observation group compared with that of the control group at one week was as AST（t=8.03，P＝0.0018）ALT（t=9.09，P＝0.0053）TBIL（t=6.60，P＝0.0041）and at 2 week as AST（t=5.59，P＝0.0012）ALT（t=6.60，P＝0.0041）TBIL（t=8.45，P﹤0.0062）。The renal function of the observation group compared with that of the control group after on