伊曲康唑序贯疗法治疗老年MODS患者侵袭性肺部真菌感染14例

目的 观察伊曲康唑序贯疗法治疗老年多脏器功能障碍综合征（MODS）患者侵袭性肺部真菌感染的疗效。方法 回顾分析重症监护病房（ICU）中，老年MODS患者侵袭性真菌感染14例，最初应用伊曲康唑注射液7～14d，第1～2d，200mg，1次／12h，第3～14d，200mg，1次／d；然后，采用伊曲康唑胶囊或口服液序贯治疗，400mg／d剂量水平，疗程2—4周。结果 临床有效率85．7％，真菌清除率为92．9％，真菌清除平均天数为6．1d；患者28d生存率85．7％，不良反应发生率为42．9％。结论 对老年MODS合并侵袭性真菌感染患者在综合治疗的基础上，应用广谱抗真菌药物——伊曲康唑序贯疗法，是巩固疗效，防止复发值得推广的给药方式。临床应用伊曲康唑时，应注意适应证、药物不良反应及药物的相互作用。

Efficacy and safety of intravenous itraconazole in treatment of invasive fungal infected patients with multiple organ dysfunction syndrome

Objective To evaluate the clinical efficacy and safety of intravenous itraconazole(Sporanox) in treatment of invasive fungal infected patients with multiple organ dysfunction syndrome(MODS).Methods Fourteen patients with invasive fungal infection in ICU, received 1~2 weeks of intravenous itraconazole (200 mg twice daily for 2 days, then 200 mg once daily for 3~14 days) followed by 2 weeks of oral itraconazole capsules 200 mg twice daily. The patients with ARF(acute renal failure ) received CRRT(continuous renal replace therapy) treatment.Results Itraconazole was effective in treatment of invasive fungal infection in ICU.The eradication rate of fungi was 92.9,effective rate 85.7,and incidence of adverse reaction 42.9.Conclusion Intravenous itraconazole followed by oral itraconazole is an effective choice for the treatment of invasive fungal infections.