评价泊沙康唑预防血液系统疾病患者粒细胞缺乏期侵袭性真菌病的效果

发布时间：2018-04-19 07:11

本文选题：泊沙康唑 + 急性白血病　；参考：《中国感染控制杂志》2017年01期

【摘要】：目的评价泊沙康唑作为血液系统疾病患者粒细胞缺乏期侵袭性真菌病(IFD)预防用药的疗效和安全性。方法通过回顾性分析北京某院2014—2015年18例血液系统疾病患者在粒细胞缺乏期应用泊沙康唑单药预防IFD的病历,评价其疗效和安全性。结果 18例患者中,预防用药期间无1例出现临床诊断或确诊IFD,无1例因严重不良反应停用泊沙康唑。2例急性髓系白血病(AML)患者因肺部感染死亡,其中1例在预防用药第12天痰培养出嗜麦芽窄食单胞菌,另1例在预防用药第14天痰培养出大肠埃希菌。其余患者均坚持预防用药至粒细胞计数恢复,随访至预防用药100 d后无死亡。预防用药期间最低外周血中性粒细胞计数为(0.00~0.27)×109/L,中位数为0.02×109/L;泊沙康唑预防用药持续时间为8~27 d,中位数为16 d;无IFD突破以及合并全身性使用其他抗真菌药者,100日内全因死亡2例(11.1%);未出现2级及以上肝功能异常、2级及以上肾功能异常以及QTc延长等不良反应。结论应用泊沙康唑预防该组血液系统疾病患者粒细胞缺乏期IFD有效,也未出现严重不良反应。
[Abstract]:Objective to evaluate the efficacy and safety of posaconazole as a prophylactic agent for granulocytic invasive mycosis (IFD) in patients with hematological diseases.Methods the medical records of 18 patients with hematological diseases who were treated with posaconazole in the period of granulocytosis in 2014-2015 were analyzed retrospectively to evaluate the efficacy and safety of prophylaxis of IFD.Results among the 18 patients, there was no clinical diagnosis or diagnosis of IFD during prophylaxis, and no case died from pulmonary infection in 2 patients with acute myeloid leukemia (AMLs) because of serious adverse reactions.One case had sputum culture of Stenotrophomonas maltophilia on the 12th day of prophylactic medication and the other case had sputum culture of Escherichia coli on the 14th day of prophylactic medication.All the other patients insisted on prophylactic medication until the granulocyte count recovered, and there was no death after 100 days follow-up.Minimum peripheral blood neutrophil count during prophylaxis was 0.000.27) 脳 10 9 / L, median 0.02 脳 10 9 / L; prophylaxis duration of posaconazole was 827 days, median 16 days; no IFD breakthrough and systemic use of other antifungal drugs, 100 days.There were no adverse reactions such as grade 2 or above grade 2 or above renal dysfunction and QTc prolongation.Conclusion posaconazole is effective in the prevention of IFD during granulocytosis in patients with hematological diseases.
【作者单位】：中国医学科学院北京协和医院;
【分类号】：R55;R519

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