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目的探讨伊曲康唑治疗肺结核合并肺部真菌感染的临床疗效及CT在疗效评价中的价值。方法随机选取呼吸内科肺结核合并肺部真菌感染患者56例,患者均给予伊曲康唑联合抗结核治疗,并于治疗前后行CT检查,统计分析治疗1、2、6周的综合临床疗效、真菌学的疗效与实验室指标之间的变化;评价CT在疗效评估中的价值。结果治疗6周后的治疗有效率与真菌清除率分别为91.07%、89.29%,明显高于治疗1周与2周后,差异有统计学意义(均P<0.05);治疗后WBC(6.38±2.07)×109/L,(1,3)-β-D葡聚糖(17.86±8.74)ng/L,显著优于治疗前(t=6.98、56.21,P<0.05);治疗前后肝肾功能指标之间的比较差异无统计学意义;出现不良反应的患者低达4例(7.14%);治疗后的CT检查异常征象发生率显著低于治疗前(均P<0.05)。结论伊曲康唑治疗肺结核合并肺部真菌感染的疗效佳,无明显的肝肾功能损害,不良反应少,CT在疗效评价中具有重要的临床价值。
Objective To investigate the clinical efficacy of itraconazole in the treatment of pulmonary tuberculosis complicated with pulmonary fungal infection and the value of CT in evaluating the curative effect. Methods Fifty-six patients with pulmonary tuberculosis complicated with pulmonary fungal infection were randomly selected. All patients were given itraconazole in combination with anti-TB therapy. CT examination was performed before and after treatment. The comprehensive clinical efficacy at 1, 2 and 6 weeks of treatment was analyzed. Learning efficacy and laboratory changes between indicators; evaluation of the value of CT in the evaluation of the efficacy. Results After 6 weeks of treatment, the effective rates of treatment and fungal clearance were 91.07% and 89.29%, respectively, which were significantly higher than those of 1 and 2 weeks after treatment (all P <0.05) 2.07) × 109 / L and (1,3) -β-D-dextran (17.86 ± 8.74) ng / L were significantly better than those before treatment (t = 6.98,56.21, P <0.05) There were no significant differences between the two groups in the index of adverse reactions. There were 4 patients (7.14%) with adverse reactions. The incidence of CT abnormalities after treatment was significantly lower than that before treatment (all P <0.05). Conclusion Itraconazole treatment of pulmonary tuberculosis complicated with pulmonary fungal infection with good effect, no significant liver and kidney dysfunction, fewer adverse reactions, CT in the evaluation of the efficacy of an important clinical value.