泊沙康唑一级预防造血干细胞移植患者侵袭性真菌病的效果及安全性评估

发布时间：2018-01-12 21:21

本文关键词：泊沙康唑一级预防造血干细胞移植患者侵袭性真菌病的效果及安全性评估　出处：《中国实验血液学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:观察泊沙康唑用于造血干细胞移植(allo-HSCT)中一级预防侵袭性真菌病(IFD)的效果及安全性。方法:45例allo-HSCT无IFD的患者从预处理开始应用泊沙康唑,直至患者的中性粒细胞恢复至0.5×10~9/L以上为止,35例以米卡芬净预防IFD患者为对照(对照组),分析2组间IFD易感因素有无差异,比较2组IFD发生率及药物不良反应的差异。结果:移植后100 d内共有13例(16%)发生IFD,其中5例(38%)死亡,而67例未发生IFD患者中10例(15%)死亡,2组间总生存率差异有统计学意义(P=0.027)。45例泊沙康唑一级预防组中发生IFD者4例(9%),对照组中35例患者发生IFD 9例(26%),2组IFD发生率差异有统计学意义(P=0.043)。在IFD风险因素评估和不良反应评估方面,2组之间无统计学差异(P0.05)。结论:应用泊沙康唑对allo-HSCT患者行IFD的一级预防的效果明显优于米卡芬净,且患者对治疗的耐受性良好。
[Abstract]:Objective: to observe the primary prevention of invasive mycosis by posaconazole in hematopoietic stem cell transplantation (HSCT). Methods 45 patients with allo-HSCT without IFD were treated with posaconazole from preconditioning. Until neutrophils recovered to 0.5 脳 10 ~ (9) / L or more, 35 patients with IFD were treated with mikafenin as control group (control group). The risk factors of IFD were analyzed between the two groups. Results: within 100 days after transplantation, there were 13 patients with IFD and 16 patients with IFD, 5 of them died. Of the 67 patients without IFD, 10 died. The overall survival rate was significantly different between the two groups. There were 4 cases of IFD in the primary prophylaxis group of posaconazole and 9 cases in the 45 cases of primary prophylaxis of posaconazole (P < 0. 027). There were significant differences in the incidence of IFD between the two groups in 35 patients with IFD in the control group (P 0.043). The risk factors and adverse reactions of IFD were evaluated. There was no statistical difference between the two groups (P 0.05). Conclusion: posaconazole is more effective than mikafenjing in the primary prevention of IFD in patients with allo-HSCT. And the patient has good tolerance to treatment.
【作者单位】：解放军总医院第一附属医院血液科;
【分类号】：R457.7;R519
【正文快照】： 吴亚妹,曹永彬,李晓红,徐丽昕,闫蓓,李松威,汪海涛,高亚会,张甜甜,张雅茜,王丽,吴晓雄*解放军总医院第一附属医院血液科,北京100048J Exp Hematol 2017;25(3):885-889侵袭性真菌病(invasive fungal disease,IFD)是异基因造血干细胞移植(allo-HSCT)过程中常见的严重并发症。大

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