Objective:To study the clinical effect of Zhenqi Fuzheng capsules, clindamycin combined with low-dose compound sulfamethoxazole in the treatment of non-HIV-infected pneumocystis pneumonia (NH-PCP). Methods:Nity-three cases of NH-PCP treated in our hospital were randomly divided into the control group (n=46) and the combined medication group (n=47).The control group was treated with conventional-dose compound sulfamethoxazole and the combined medication group was treated with Zhenqi Fuzheng capsules,clindamycin and low-dose compound sulfamethoxazole.Blood routine indexes,blood oxygen indexes, related serum biomarkers and immune function indexes were detected and compared between the two groups before and after treatment. The clinical efficacy and the adverse reactions of the two groups was compared. Results:The levels of lymphocyte count (LYM)and albumin (ALB) in the blood routine indexes, blood oxygen indexes,related serum biomarkers and immune function indexes in the combined medication group were significantly better than those in the control group (P<0.05).The total effective rate of the combined medication group was significantly higher that of the control group (91.49% vs.76.09%,χ2=4.077,P=0.043).The incidence of adverse reactions in the combined medication group was significantly lower than that of the control group (P<0.05). Conclusions:Zhenqi Fuzheng capsules,clindamycin combined with low-dose compound sulfamethoxazole in the treatment of NH-PCP can significantly improve the clinical efficacy,promote LYM,ALB and blood oxygen indexes,improve related serum biomarkers and immune function.It is safe and worthy of clinical application. |
[1] 曾健生,钱素云.肺孢子菌肺炎的诊断与治疗[J].中华实用儿科临床杂志,2012,27(18):1453-1456.
[2] 李晓亮,马希涛.肺孢子菌肺炎研究进展[J].中华实用诊断与治疗杂志,2014,28(11):1049-1051.
[3] BIENVENU A L,TRAORE K,PLEKHANOVA I,et al.Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients[J].Int J Infect Dis,2016,46:11-17.
[4] TASAKA S,TOKUDA H.Pneumocystis jirovecii pneumonia in non-HIV-infected patients in the era of novel immunosuppressive therapies[J].J Infect Chemother,2012,18(6):793-806.
[5] 徐丽婷,李欢欢,张娟红,等.卡氏肺孢子菌肺炎药物治疗研究进展[J].兰州大学学报:医学版,2017,43(2):66-71.
[6] CHANG H M,TSAI H C,LEE S S,et al.High daily doses of trimethoprim/sulfamethoxazole are an independent risk factor for adverse reactions in patients with pneumocystis pneumonia and AIDS[J].J Chin Med Assoc,2016,79(6):314-319.
[7] 陈钟,肖钢,周泉,等.克林霉素联合复方磺胺甲口恶唑片治疗艾滋病合并肺孢子菌肺炎的疗效分析[J].中国感染控制杂志,2016,15(10):773-776.
[8] LI H,HUANG H,HE H.Successful treatment of severe Pneumocystis pneumonia in an immunosuppressed patient using caspofungin combined with clindamycin:a case report and literature review[J].BMC Pulm Med,2016,16(1):144.
[9] 中华医学会呼吸病学分会感染学组.肺真菌病诊断和治疗专家共识[J].中华结核和呼吸杂志,2007,30(11):821-834.
[10] 魏月霞,相巧丽,姚彦芬,等.卡泊芬净联合胸腺肽及小剂量复方新诺明治疗肺孢子菌肺炎25例体会[J].临床合理用药,2015,8(10A):162-163.
[11] LI M C,LEE N Y,LEE C C,et al.Pneumocystis jiroveci pneumonia in immunocompromised patients:Delayed diagnosis and poor outcomes in non-HIV-infected individuals[J].J Microbiol Immunol Infect,2014,47(1):42-47.
[12] NAKASHIMA K,AOSHIMA M,NAKASHITA T,et al.Low-dose trimethoprim-sulfamethoxazole treatment for pneumocystis pneumonia in non-human immunocompromised patients:A single-center retrospective observational cohort study[J].J Microbiol Immunol Infect,2017:in press.
[13] 张燕,许小凤,陈翊,等.贞芪扶正胶囊联合化疗对中晚期宫颈癌患者的疗效及免疫功能影响[J].现代生物医学进展,2016,16(36):7117-7120.
[14] SALERNO D,MUSHATT D,MYERS L,et al.Serum and bal beta-D-glucan for the diagnosis of Pneumocystis pneumonia in HIV positive patients[J].Respir Med,2014,108(11):1688-1695.
[15] 叶宁,朱明利,李茜茜,等.肺孢子菌肺炎实验室诊断研究进展[J].中国卫生检验杂志,2017,27(4):604-605.
[16] LI Y,GHANNOUM M,DENG C,et al.Pneumocystis pneumonia in patients with inflammatory or autoimmune diseases:Usefulness of lymphocyte subtyping[J].Int J Infect Dis,2017,57:108-115. |