Article(id=1292126367538238105, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126355785802497, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.04.001, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750348800000, receivedDateStr=2025-06-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785996532568, onlineDateStr=2026-08-06, pubDate=1772208000000, pubDateStr=2026-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785996532568, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785996532568, creator=13701087609, updateTime=1785996532568, updator=13701087609, issue=Issue{id=1292126355785802497, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='4', pageStart='451', pageEnd='600', issueExtLink='null', onlineDate='null', pubDate='1772208000000', pubDateStr='2026-02-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785996529766, creator='13701087609', updateTime=1786014519902, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201811952292026, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126355785802497, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201811952292027, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126355785802497, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=451, endPage=456, ext={EN=ArticleExt(id=1292126367773119130, articleId=1292126367538238105, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of posaconazole and voriconazole in patients with pulmonary tuberculosis complicated by invasive pulmonary aspergillosis, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of posaconazole injection and voriconazole injection in the treatment of patients with pulmonary tuberculosis complicated with invasive pulmonary aspergillosis (IPA).
Methods Patients with pulmonary tuberculosis complicated with IPA were divided into control group and treatment group according to the treatment methods. Both groups maintained standardized anti-tuberculosis treatment. At the same time, the control group was given voriconazole for injection at a dose of 6 mg·kg-1 ivgtt, q12 h on the first day; from the second day, 4 mg·kg-1 ivgtt, q12 h. When the patient’s clinical condition was stable, switched to oral voriconazole tablets, 200 mg per dose, q12 h. Treatmen group was also given posaconazole injection, initially intravenously, with a dose of 300 mg ivgtt, q12 h on the first day; from the second day, 300 mg ivgtt, qd; when the patient’s clinical condition was stable, oral posaconazole oral suspension were switched to, 400 mg each time, bid. Both groups were treated for 12 weeks. The clinical efficacy, clinical symptom relief, galactomannan (GM) and 1-3-β-D glucan (BG) levels, lung function parameters, immune and inflammatory indicators were compared between the two groups of patients, and safety evaluation was carried out.
Results A total of 84 patients were enrolled, with 43 cases in control group and 41 cases in treatment group. The clinical effective rates in control group and treatment group were 79.07% (34 cases/43 cases) and 87.80% (36 cases/41 cases), respectively, with no statistically significant difference (P>0.05). The fever subsided time in control group and treatment group were (7.53±1.39) and (8.37±1.65) d, respectively; the recovery time of respiratory function were (5.26±1.66) and (4.44±1.70) months, respectively; the GM levels were (0.44±0.13) and (0.36±0.11) ng·mL-1, respectively; BG levels were (25.62±5.86) and (22.77±5.34) pg·mL-1, respectively; the arterial oxygen saturation (SaO2) levels were (95.63±1.70)% and (96.56±1.70)%, respectively; the pulmonary dynamic compliance (Cdyn) levels were (32.25±4.65) and (34.72±4.49) mL·cm H2O-1, respectively; the levels of response frequency (Fres) were (11.39±1.78) and (10.46±1.75) Hz, respectively; the levels of maximum ventilation (MVV) were (78.12±8.87) and (83.68±8.19) L·min-1, respectively; the carbon monoxide diffusing capacity (DLCO) levels were (62.93±4.37)% and (65.44±4.11)%, respectively; the levels of interleukin 5 (IL-5) were (1.31±0.38) and (1.11±0.32) ng·L-1, respectively; the levels of interleukin 17 (IL-17) were (14.54±2.83) and (13.22±2.57) ng·L-1, respectively; the levels of dendritic cell-associated C-type lectin-1 (Dectin-1) were (11.86±2.25) and (10.58±2.13) ng·L-1, respectively; the immunoglobulinM (IgM) levels were (1.13±0.33) and (1.33±0.26) g·L-1, respectively; the immunoglobulin E (IgE) levels were (1.09±0.27) and (0.90±0.25) g·L-1, respectively. There were statistically significant differences in the above indexes between treatment group and control group (P<0.05, P<0.01). Regarding adverse drug reactions, control group primarily experienced nausea, elevated alanine aminotransferase, increased alkaline phosphatase and hallucinations, whereas the treatment group mainly reported nausea, vomiting, elevated alanine aminotransferase, elevated aspartate aminotransferase and hypokalemia. The total incidence of adverse drug reactions was 13.95% (6 cases/43 cases) in control group and 14.63% (6 cases/41 cases) in treatment group, with no statistically significant difference between two groups (P>0.05).
Conclusion Both posaconazole injection and voriconazole injection can achieve good clinical responses in the treatment of patients with pulmonary tuberculosis complicated by IPA. Posaconazole has advantages in reducing fungal burden, improving lung function, and regulating immune inflammation. The safety of the two groups is equivalent. Posaconazole may have a slower onset of action, manifested by a longer time to resolve fever, but the long-term benefit in lung function is more significant.
, authors=Hou-tong ZHAO, Lu HAN, Bi CHEN, Hao CHEN, Li-xiang SUN, authorsList=Hou-tong ZHAO, Lu HAN, Bi CHEN, Hao CHEN, Li-xiang SUN, authorCompany=null, correspAuthors=Li-xiang SUN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1292126367995417243, articleId=1292126367538238105, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=泊沙康唑与伏立康唑治疗肺结核并发侵袭性肺曲霉病患者的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 观察泊沙康唑注射液与注射用伏立康唑治疗肺结核并发侵袭性肺曲霉病（IPA）患者的临床疗效和安全性。
方法 将肺结核并发IPA患者根据治疗方法分为对照组和试验组。2组均维持规范的抗结核治疗，同时，对照组给予注射用伏立康唑，首日剂量6 mg·kg-1静脉注射，q12 h；从第2天起，4 mg·kg-1静脉注射，q12 h；当患者临床稳定后，转为口服伏立康唑片，每次200 mg，q12 h。试验组同时给予泊沙康唑注射液，初始静脉给药，首日剂量300 mg静脉注射，q12 h；从第2天起，300 mg静脉注射，qd；当患者临床稳定后，转为泊沙康唑口服混悬液，每次400 mg，bid。2组均治疗12 w。比较2组患者的临床疗效、临床症状缓解情况、半乳甘露聚糖（GM）和1-3-β-D葡聚糖（BG）水平、肺功能参数和免疫及炎症指标，并进行安全性评价。
结果 共纳入84例患者，其中对照组43例、试验组41例。对照组和试验组的临床有效率分别为79.07%（34例/43例）和87.80%（36例/41例），在统计学上差异无统计学意义（P>0.05）。对照组和试验组发热消退时间分别为（7.53±1.39）和（8.37±1.65）d，呼吸功能恢复时间分别为（5.26±1.66）和（4.44±1.70）月，GM水平分别为（0.44±0.13）和（0.36±0.11）ng·mL-1，BG水平分别为（25.62±5.86）和（22.77±5.34）pg·mL-1，血氧饱和度（SaO2）水平分别为（95.63±1.70）%和（96.56±1.70）%，肺动态顺应性（Cdyn）水平分别为（32.25±4.65）和（34.72±4.49）mL·cm H2O-1，肺响应频率（Fres）水平分别为（11.39±1.78）和（10.46±1.75）Hz，最大通气量（MVV）水平分别为（78.12±8.87）和（83.68±8.19）L·min-1，一氧化碳弥散量（DLCO）水平分别为（62.93±4.37）%和（65.44±4.11）%，白细胞介素-5（IL-5）水平分别为（1.31±0.38）和（1.11±0.32）ng·L-1，白细胞介素-17（IL-17）水平分别为（14.54±2.83）和（13.22±2.57）ng·L-1，树突状细胞相关性C-型凝集素-1（Dectin-1）水平分别为（11.86±2.25）和（10.58±2.13）ng·L-1，免疫球蛋白M（IgM）水平分别为（1.13±0.33）和（1.33±0.26）g·L-1，免疫球蛋白E（IgE）水平分别为（1.09±0.27）和（0.90±0.25）g·L-1，试验组的上述指标与对照组比较，在统计学上差异均有统计学意义（P<0.05，P<0.01）。对照组的药物不良反应主要有恶心、丙氨酸转氨酶增高、碱性磷酸酶增高和幻觉，试验组的药物不良反应主要有恶心、呕吐、丙氨酸转氨酶增高、天冬氨酸转氨酶增高和低钾血症。对照组和试验组的药物不良反应总发生率分别为13.95%（6例/43例）和14.63%（6例/41例），在统计学上差异无统计学意义（P>0.05）。
结论 泊沙康唑注射液与注射用伏立康唑治疗肺结核并发IPA患者均可获得良好临床应答，泊沙康唑在降低真菌负荷、改善肺功能、调节免疫炎症方面更具优势，2者安全性相当。泊沙康唑起效可能较慢，表现为发热消退时间延长，但远期肺功能获益更显著。
, authors=赵后彤, 韩露, 陈碧, 陈昊, 孙理想, authorsList=赵后彤, 韩露, 陈碧, 陈昊, 孙理想, authorCompany=null, correspAuthors=孙理想, authorNote=
赵后彤（1990-），女，主治医师，主要从事肺癌方面的临床工作和研究
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