|
|
The Efficacy and Mechanism of Itraconazole in the Treatment of COPD Complicated with Pulmonary Fungal Infection |
HOU Fujian, WEI Zhaohui, ZHAO Yuewei |
Department of Respiratory Medicine ,Dingzhou People's Hospital,Dingzhou Hebei 073000 |
|
|
Abstract 【Objective】To explore the therapeutic effect and possible mechanism of itraconazole in the treatment of chronic obstructive pulmonary disease(COPD) with fungal infection. 【Methods】A retrospective analysis was conducted on the clinical data of 80 COPD patients with pulmonary fungal infections admitted to our hospital from January 2019 to December 2021. According to different treatment methods, they were divided into the itraconazole group(treated with itraconazole) and the fluconazole group(treated with fluconazole), with 40 cases in each group. We compared the length of hospital stay, mortality rate, incidence of adverse reactions, and serum levels of tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), interleukin-1β(IL-1β), interleukin-2(IL-2), interleukin-4(IL-4), and interleukin-10(IL-10) before and after treatment between two groups.【Results】The hospitalization time of the itraconazole group was shorter than that of the fluconazole group(P<0.05), and the mortality rate was lower than that of the fluconazole group(P<0.05). Before treatment, there was no statistically significant difference in serum levels of TNF-α, IFN-γ, IL-1β, IL-2, IL-4, and IL-10 between the two groups of patients(P>0.05); After treatment, the serum levels of TNF-α, IL-2, IL-4, and IL-10 in the itraconazole group were lower than those in the fluconazole group(P<0.05), and the levels of IFN-γ were higher than those in the fluconazole group(P<0.05); The incidence of adverse reactions in the itraconazole group was 30.00%, significantly lower than the 37.50% in the fluconazole group, and the difference was statistically significant(P<0.05). 【Conclusion】The use of itraconazole in the treatment of COPD patients with pulmonary fungal infection has a good clinical effect, and its possible mechanism of action is to regulate the level of inflammatory factors.
|
Received: 14 March 2023
|
|
|
|
|
[1] 包鹤龄,方利文,王临虹,等.1990-2014年中国40岁及以上人群慢性阻塞性肺疾病患病率Meta分析[J].中华流行病学杂志,2016,37(1):119-124. [2] 石卫霞,林英翔,朱建国,等.慢性阻塞性肺疾病急性加重期患者继发真菌感染的危险因素分析[J].中国医药,2016,11(1):34-37. [3] 黎伟,王宋平.伊曲康唑在COPD并发真菌感染患者中的应用效果[J].中华医院感染学杂志,2018,28(9):1309-1312. [4] 祖育娜,张华.国产氟康唑片局部用药治疗慢性阻塞性肺疾病合并口腔念珠菌病的临床观察[J].实用医学杂志,2016,32(11):1855-1857. [5] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264. [6] 中华内科杂志编辑委员会.侵袭性肺部真菌感染的诊断标准与治疗原则(草案)[J].中华内科杂志,2006,45(8):697-700. [7] 蒋红云.慢性阻塞性肺疾病患者继发真菌性肺炎的特点及耐药情况[J].临床肺科杂志,2016,21(11):2009-2011. [8] 刘永娟,戚明,门浩,等.慢性阻塞性肺疾病患者肺部真菌感染与耐药性研究[J].中华医院感染学杂志,2016,(3):578-579. [9] 何薇.慢性阻塞性肺疾病老年患者并发肺部真菌感染的危险因素[J].中国生化药物杂志,2016,36(4):176-178. [10] ALVAREZMORENO C A, CORTES J A, DENNING D W. Burden of fungal infections in Colombia [J].J Fungi,2018, 4(2):41. [11] 朱曼,郭茂文,郭代红,等.三唑类抗真菌药物的药源性肝损伤主动监测研究[J].中国药物应用与监测,2017,14(1):45-47. [12] 胡伟,李尔然.高龄医院获得性肺炎患者预防性应用氟康唑抗真菌治疗的疗效分析[J].中国医学创新,2016,13(29):115. [13] 张琰,王改锋,王升,等.伊曲康唑对白血病患者化疗期间真菌感染的治疗效果[J].中华医院感染学杂志,2017,27(20):4633-4636. [14] WRENCH C, KBR B, BERCUSSON A, et al. Reduced clearance of fungal spores by chronic obstructive pulmonary disease GM-CSF-and M-CSF-derived macrophages[J].Am J Respir Cell Mol Biol,2018, 58(2):271-273. [15] 孙丽,黄惠雪,白雪,等.肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J].中国康复医学杂志,2016,31(4):434-438. [16] 杨凌婧.稳定期中重度慢阻肺患者血清IL-6、IL-8、TNF-α、hs-CRP与肺功能的相关性研究[J].临床肺科杂志,2016,21(3):481-484. [17] 崔海燕,唐神结,沈芸,等.肺结核合并慢性阻塞性肺疾病患者细胞免疫状态评价[J].中华临床医师杂志(电子版),2016,10(20):3002-3008. [18] 王悦颖,林梅,王蕾,等.慢性牙周炎和慢性牙周炎合并慢性阻塞性肺疾病患者血清中IL-2、IL-4、IL-6、IL-10、IFN-γ及TNF-α的检测及临床意义[J].中国医师杂志,2017,19(8):1148-1151. [19] 武红莉,田瑞雪,宁兰丁,等.慢性阻塞性肺疾病患者肺部感染的影响因素分析及血清炎症因子水平变化分析[J].中华医院感染学杂志,2018,28(1):25-28. [20] 肖祖克,孙慧,叶东,等.炎琥宁对COPD大鼠肺组织IL-12/STAT4、IL-4/STAT6信号通路影响探讨[J].江西医药,2018,53(1):83-84. [21] 张晓慧.炎性细胞因子水平检测对慢性阻塞性肺疾病的临床意义[J].海南医学院学报,2016,22(3):240-242. [22] 郭丹丹,李娟,董金玲,等.伏立康唑治疗肝功能衰竭合并肺真菌感染十例不良反应分析[J].中华传染病杂志,2016,34(11):682-683. |
|
|
|