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目的比较米卡芬净与两性霉素B脂质体治疗ICU婴幼儿侵袭性肺部真菌感染(IPFI)的疗效和安全性。方法回顾性分析本院ICU中IPFI婴幼儿48例,按抗真菌药物使用类别分为米卡芬净组和两性霉素B脂质体组。其中米卡芬净组26例,两性霉素B脂质体22例。分别予抗真菌治疗至体温正常5 d或疗程大于10 d,观察2组疗效及不良反应。结果米卡芬净组痊愈12例,显效7例,有效率73.08%;不良反应2例(占7.69%)。两性霉素B脂质体组痊愈8例,显效7例,有效率68.18%;9例(40.91%)有不良反应。2组治疗有效率比较无统计学差异(P>0.05),但米卡芬净组不良反应率低于两性霉素B脂质体组(P<0.01)。结论对IPFI婴幼儿抗真菌治疗,米卡芬净的疗效与两性霉素B脂质体基本相同,但耐受性较两性霉素B脂质体好,安全性高。
Objective To compare the efficacy and safety of micafungin and amphotericin B liposomes in the treatment of infant pulmonary invasive fungal infection (IPFI) in ICU. Methods Retrospective analysis of 48 cases of IPFI infants and young children in our hospital ICU, according to the use of antifungal drugs divided into micafungin net group and amphotericin B liposome group. Among them, 26 cases were treated with micafungin and 22 cases were amphotericin B liposomes. Respectively antifungal therapy to normal body temperature 5d or more than 10d, the two groups were observed efficacy and adverse reactions. Results In the micafungin net group, 12 cases were cured, and 7 cases were markedly effective, with an effective rate of 73.08%. Two cases were adverse reactions (accounting for 7.69%). Amphotericin B liposome group cured in 8 cases, markedly effective in 7 cases, the effective rate was 68.18%; 9 cases (40.91%) had adverse reactions. There was no significant difference between the two groups (P> 0.05), but the adverse reaction rate of micafungin group was lower than that of amphotericin B liposome group (P <0.01). Conclusion IPFI infant antifungal therapy, micafungin net efficacy and amphotericin B liposomes are basically the same, but the tolerance than amphotericin B liposomes, high safety.