标题：伏立康唑雾化吸入对侵袭性肺曲霉病患者细胞因子及肺纤维化的影响

      作者：张贵宁 1，危之屏 2，叶明霞 3
    (1.深圳市眼科医院药剂科，广东 深圳 518040；
2.北京大学深圳医院药剂科，广东 深圳 518036；
3.北京大学深圳医院呼吸内科，广东 深圳 518036)

      卷次： 2015年26卷6期

      【摘要】 目的 探讨伏立康唑雾化吸入对侵袭性肺曲霉病(IPA)患者细胞因子及肺纤维化的影响。方法 选择
2010年1月至2013年12月期间我院收治的68例IPA患者为研究对象，将其随机分为观察组和对照组。观察组36例患
者给予伏立康唑雾化吸入，对照组32例患者给予伏立康唑静脉滴注治疗。比较两组患者的治疗效果，血清 IL-6、
IL-8、TNF-α水平以及肺总量(TCL)、一氧化碳弥散量(DLco)和血氧饱和度(SaO2)。结果 观察组有效率为
86.11%，优于对照组的65.63%，差异有统计学意义(P<0.05)。治疗后两组TCL、DLco、SaO2均较治疗前明显改善
(P<0.05)，但观察组TCL、DLco、SaO2改善幅度大于对照组(P<0.05)。观察组治疗后血清TNF-α水平明显较治疗
前降低(P<0.05)，也明显低于同期对照组(P<0.05)。观察组治疗后血清 IL-8、IL-6水平明显较治疗前降低
(P<0.05)，也明显低于同期对照组(P<0.05)。对照组治疗后血清TNF-α、IL-8、IL-6水平低于治疗前(P<0.05)。观
察组和对照组不良反应发生率分别为8.33%和6.25%，差异无统计学意义(P>0.05)。结论 伏立康唑雾化吸入用
于 IPA的治疗，可有效改善患者肺纤维化程度，抑制炎症反应，临床疗效佳，且不良反应轻。

      【关键词】 侵袭性肺曲霉病；伏立康唑；雾化吸入；肺纤维化；细胞因子

      【中图分类号】 R379.6 【文献标识码】 A 【文章编号】 1003—6350（2015）06—0787—04


Influence of voriconazole atomization inhalation on pulmonary fibrosis and cytokines in patients with invasive
pulmonary aspergillosis.
ZHANG Gui-ning 1, WEI Zhi-ping 2, YE Ming-xia 3. 1. Department of Pharmacy, Shenzhen
Eye Hospital, Shenzhen 518040, Guangdong, CHINA; 2. Department of Pharmacy, Peking University Shenzhen Hospital,
Shenzhen 518036, Guangdong, CHINA; 3. Department of Respiratory Medicine, Peking University Shenzhen Hospital,
Shenzhen 518036, Guangdong, CHINA

【Abstract】 Objective To study the influence of voriconazole atomization inhalation on pulmonary fibrosis
and cytokines in patients with invasive pulmonary aspergillosis (IPA). Methods Sixty-eight IPA patients in our hospi-
tal from Jan. 2010 to Dec. 2013 were selected as the research objects, which were randomly divided into observation
group and control group. Patients in the observation group (n=36) were given voriconazole inhalation, while those in
the control group (n=32) were given voriconazole by intravenous drip treatment. The curative effects, the serum IL-6,
IL-8, TNF-α levels, total lung capacity (TCL), diffusing capacity for carbon monoxide (DLco), oxygen saturation
(SaO2) of the two groups were recorded. Results The efficient rate of observation group was significantly better
than the control group (86.11% vs 65.63%, P<0.05). After treatment, TCL, DLco, SaO2 in observation group and the
control group were all significantly improved (P<0.05), but the improvement in the observation group were more sig-
nificant (P<0.01). After treatment, the serum TNF-α levels were significantly lower than those before treatment (P<
0.01) and were significantly lower than control group in the same period (P<0.01). Serum IL-8, IL-6 levels in the ob-
servation group after treatment were significantly lower than those before treatment (P<0.01) and were significantly
lower than control group in the same period (P<0.01). Serum TNF-α, IL-8, IL-6 levels in the control group after
treatment were significantly lower than those before treatment (P<0.05). The incidence of adverse reactions in the
observation group and the control group were 8.33% and 6.25%, and there were no significant differences (P>0.05).
Conclusion Voriconazole inhalation for the treatment of IPA can effectively improve the patients' pulmonary fibro-
sis, inhibit the inflammatory reaction, which has better clinical effect and less adverse reactions.