真菌性食管炎患者抗真菌治疗期间血常规、免疫功能动态变化的特征分析

摘要/Abstract

摘要： 目的分析真菌性食管炎患者接受抗真菌治疗期间血常规及免疫功能动态变化的特征。方法将我院收治的42例真菌性食管炎患者纳入实验组，给予患者氟康唑联合克霉唑抗真菌治疗；同期收治的42例反流性食管炎纳入对照组，给予常规治疗。两组分别于入院时、治疗1 d、3 d、5 d、7 d及14 d，动态开展血常规检查及免疫功能指标监测。治疗过程中，观察两组不良反应。结果治疗期间，实验组白细胞计数呈下降趋势，中性粒细胞百分比则呈上升趋势；对照组白细胞计数呈下降趋势，中性粒细胞无明显变化。治疗1 d、3 d、5 d、7 d、14 d，组间白细胞计数差异显著（P<0.05）；入院时、治疗1 d、3 d、5 d、7 d，组间中性粒细胞对比差异显著（P<0.05），治疗14 d，组间中性粒细胞百分比差异不显著（P>0.05）。实验组、对照组CRP均呈下降趋势，治疗1 d、3 d、5 d、7 d、14 d CRP水平组间对比差异有统计学意义（P<0.05）；实验组、对照组食管炎患者IgM及IgG均呈升高趋势，治疗1 d、3 d、5 d、7 d、14 d对比，两组差异均具有统计学意义（P<0.05）。结论真菌性食管炎患者多伴明显免疫功能下降、中性粒细胞比例降低。治疗期间，血常规检查、免疫功能的动态监测可为真菌性食管炎患者的疗效评估提供临床依据。

关键词: 真菌性食管炎, 抗真菌治疗, 血常规检查, 免疫功能

Abstract: Objective To analyze the dynamic changes of blood routine and immune function in patients with fungal esophagitis. Methods Fourty-two cases of mycotic esophagitis in our hospital were included in the experimental group, and the patients were given fluconazole and clotrimazole antifungal treatment; 42 cases of reflux esophagitis in the same period were included in the control group, and given routine treatment. Blood routine examination and immune function monitoring were carried out dynamically in the two groups at the time of admission, 1, 3, 5, 7 and 14 days after treatment. During the treatment, adverse reactions were observed. Results During the treatment, the white blood cell count in the experimental group showed a downward trend, while the percentage of neutrophils showed an upward trend; in the control group, the white blood cell count showed a downward trend, and there were no significant changes in the neutrophil count. There were significant differences in WBC count among the groups on 1 d, 3 d, 5 d, 7 d, 14 d after treatment (P<0.05); on admission, on 1 d, 3 d, 5 d, 7 d, the neutrophil comparison between the groups was significant (P<0.05), while on the 14th day of treatment, there were no significant differences in the percentage of neutrophils among the groups (P>0.05). CRP levels in the experimental group and the control group showed a downward trend, and there were significant differences between the two groups on the 1st, 3rd, 5th, 7th and 14th days of treatment (P<0.05); the IgM and IgG of the experimental group and the control group were increased, and the differences between the two groups were statistically significant (P<0.05). Conclusions Most of the patients with fungal esophagitis had decreased immune function and neutrophil ratio. During the treatment, routine blood test and dynamic monitoring of immune function could provide clinical basis for curative effect evaluation of patients with fungal esophagitis.

Key words: fungal esophagitis, antifungal therapy, blood routine examination, immune function

中图分类号:

R571
R519

张春梅, 赵婷, 何晓莉, 彭雷. 真菌性食管炎患者抗真菌治疗期间血常规、免疫功能动态变化的特征分析[J]. 中国真菌学杂志, 2021, 16(2): 106-110.

ZHANG Chunmei, ZHAO Ting, HE Xiaoli, PENG Lei. Dynamic changes of blood routine and immune function in patients with fungal esophagitis during antifungal therapy[J]. Chinese Journal of Mycology, 2021, 16(2): 106-110.

参考文献

[1] 黎健,张晓红,冯莉.霉菌性食管炎40例临床分析[J].中华消化病与影像杂志(电子版),2019,9(5):212-215.
[2] 李云峰,任勤芳,许翠萍.艾司奥美拉唑镁肠溶片联合布拉酵母菌散治疗真菌性食管炎疗效观察[J].中国药物与临床,2019,19(16):2840-2841.
[3] Sarbinowska JA,Was'ko-Czopnik D. High-resolution manometry in diagnostics and evaluation of therapy effectiveness in patients with eosinophilic esophagitis-underestimated breakthrough or dead end[J]. Prz Gastroenterol,2020,15(1):22-26.
[4] 虎金朋,牛敏,杨珍,等.真菌性食管炎650例临床分析[J].中华消化病与影像杂志(电子版),2019,9(4):152-155.
[5] 戴逸君,严青,高飞,等.结缔组织病合并真菌性食管炎42例临床分析及文献回顾[J].中外医学研究,2019,17(10):157-160.
[6] 沈杉杉,郭小皖,纪红,等.HIV感染者并真菌性食管炎及食管纵隔瘘一例报告[J].中国艾滋病性病,2019,25(1):88-89.
[7] Luna JM, Chao HH, Shinohara RT,et al. Machine learning highlights the deficiency of conventional dosimetric constraints for prevention of high-grade radiation esophagitis in non-small cell lung cancer treated with chemoradiation[J]. Clin Transl Radiat Oncol,2020,22(12):69-75.
[8] 黄安华,黄泳华.关于霉菌性食管炎临床特点及诊断结果的分析[J].现代医学与健康研究电子杂志,2018,2(3):44.
[9] 张建民.氟康唑对念珠菌性食管炎患者血清白介素-2水平的影响[J].现代诊断与治疗,2017,28(21):3970-3972.
[10] 张学成.消化内镜外套气囊法注射抗菌药物治疗真菌性食管溃疡36例临床分析[J].世界最新医学信息文摘,2017,17(70):94.
[11] 法欣欣.埃索美拉唑与奥美拉唑治疗反流性食管炎临床对比[J].中国继续医学教育,2017,9(5):131-133.
[12] Shen SS, Ji H, Guo XW, et al. Application of computed tomography to diagnose fungal esophagitis:one case report[J]. AIDS Res Hum Retroviruses, 2019, 35(5):161-163.
[13] 苏坤涵.通降合剂治疗肝胃郁热型反流性食管炎的疗效评价及其对肠道菌群的影响[D].南京中医药大学,2019.
[14] Ancellin M, L. Ricolfi-Waligova L, Clerc-Urmès I, et al. Management of eosinophilic esophagitis in children according to atopic status:A retrospective cohort in northeast of France[J]. Arch Pediatr, 2020, 27(3):122-127.
[15] Hiremath G, Correa H,Acra S,et al. Correlation of endoscopic signs and mucosal alterations in children with eosinophilic esophagitis[J]. Gastrointest Endosc, 2020, 91(4):785-794.