武小杰.肾移植术后并发卡氏肺孢子菌肺炎的治疗方案选择[J].内科急危重症杂志,2023,29(5):393-396
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| DOI：10.11768/nkjwzzzz20230508 |
| 中文关键词: 复方磺胺甲噁唑 卡泊芬净 卡氏肺孢子菌肺炎 肾移植 治疗结局 |
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| 中文摘要: |
| 摘要 目的：探讨肾移植术后并发卡氏肺孢子菌肺炎（PCP）患者用卡泊芬净治疗PCP感染的疗效。方法：将125例肾移植后并发PCP患者分为磺胺组（42例）、卡泊芬净组（37例）和磺胺+卡泊芬净组（46例），比较3组临床特征，分析各组治疗后患者体温恢复正常时间、卡氏肺孢子菌（PC）核酸转阴时间和治疗结局。结果：治疗前，3组患者年龄、性别、发热症状及实验室检测（G实验和乳酸脱氢酶）方面比较，差异无明显统计学意义（P均>0.05）。治疗后，磺胺组、卡泊芬净组、磺胺+卡泊芬净组体温恢复正常时间分别为（7.9±1.4）d，(8.1±1.7)d和(7.7±1.5)d，组间比较，差异无明显统计学意义（P>0.05）；PC核酸转阴时间分别为（13.4±1.6）d、（16.3±2.9）d、（13.9±2.5）d；卡泊芬净组PC核酸转阴时间明显长于磺胺组、磺胺+卡泊芬净组（P均<0.05），磺胺组和磺胺+卡泊芬净组比较，差异无明显统计学意义（P>0.05）；3组间的治疗结局比较，差异无明显统计学意义（P均>0.05）。结论：卡泊芬净单药治疗PCP能获得肯定的疗效，包括体温恢复正常、PC核酸转阴和治愈出院。卡泊芬净对于肾移植术后PCP患者的治疗是一个较好的选择。 |
| 英文摘要: |
| Abstract Objective: To investigate the efficacy of carpofungine in treating Pneumocysis carinii penumonia (PCP) after kidney transplantation. Methods: Totally, 125 patients with PCP after kidney transplantation were divided into sulfonamide group (n=42), casposungin group (n=37 cases), and sulfonamide+casposungin group (n=46 cases). The clinical features of the three groups were compared, and the time of temperature recovery, the negative conversion of pneumocystis carinii (PC) nucleic acid in each group after different treatment projects were analyzed. Results: Before the treatment, there were no significant differences in age, gender, fever symptoms, and laboratory tests (G experiment and LDH) among the three groups (P>0.05). After treatment,the days of the body temperature to the normal level in the sulfonamide group, casposungin group, and sulfonamide+casposungin group were (7.9±1.4), (8.1±1.7), and (7.7±1.5), respectively, with no significant difference among the three groups (P>0.05); The time of PC nucleic acid negative conversion in the sulfonamide group, casposungin group, and sulfonamide+casposungin group was (13.4±1.6), (16.3±2.9), and (13.9±2.5) days, respectively. The time of PC nucleic acid negative conversion in the casposungin group was significantly longer than that in the sulfonamide group and the sulfonamide+casposungin group, with a significant difference (P<0.05), but there was no significant difference between the sulfonamide group and the sulfonamide+casposungin group (P>0.05). There was no significant difference in treatment outcomes among the three groups (P>0.05). Conclusion: Carpofungin monotherapy can achieve a positive therapeutic effect on PCP, including temperature decline to normal level, the negative conversion of PC nucleic acid, and cure and discharge. Carpofungin is a good choice for the treatment of PCP after kidney transplantation. |
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