再生障碍性贫血患者侵袭性真菌病卡泊芬净治疗的临床分析

发布时间：2018-06-28 04:23

本文选题：卡泊芬净 + 再生障碍性贫血　；参考：《中华医院感染学杂志》2016年22期

【摘要】：目的探讨再生障碍性贫血(AA)患者侵袭性真菌病(IFD)卡泊芬净治疗的临床疗效及安全性,以指导治疗。方法回顾性分析医院2009年1月-2013年2月接受卡泊芬净抗真菌治疗133例疑似AA合并IFD患者临床资料,依据临床及微生物学标准评价其疗效,并观察药物的不良反应。结果 133例疑似AA合并IFD患者中,确诊4例、临床诊断21例、拟诊70例,分别占3.0%、15.8%及52.6%;129例患者呈单一部位感染,另有4例呈多部位感染;病原学检查共检出真菌46株,其中假丝酵母菌属38株,曲霉菌属8株;所有患者均具备2项以上真菌感染高危因素,具备≥3项高危因素者占94.7%;卡泊芬净中位疗程11(1~84)天,总有效率72.4%,治疗有效者中位退热时间5(1-20)天,确诊、临床诊断、拟诊及未确定患者有效率依次为50%、61.9%、77.2%及91.7%;药物相关不良反应发生率低且较轻。结论卡泊芬净抗真菌谱广泛,其疗效佳,药物相互作用少,兼具良好耐受性,尤其为治疗AA合并IFD的理想药物。
[Abstract]:Objective to evaluate the efficacy and safety of carpofen in the treatment of invasive fungal disease (AA) in patients with aplastic anemia. Methods the clinical data of 133 patients with suspected AA combined with IFD were analyzed retrospectively from January 2009 to February 2013. The therapeutic effects were evaluated according to the clinical and microbiological criteria and the adverse drug reactions were observed. Results of 133 suspected AA patients with IFD, 4 were diagnosed, 21 were clinically diagnosed, 70 were to be diagnosed, accounting for 15.8% and 52.6%, respectively, of 129 patients with single site infection and 4 with multiple site infection, 46 strains of fungi were detected by etiological examination. There were 38 strains of Candida and 8 strains of Aspergillus. All patients had more than 2 risk factors for fungal infection, 94.7% of them had more than 3 high risk factors. The median course of treatment was 11 (184) days. The total effective rate was 72.4%, the median antipyretic time was 5 (1-20) days, the effective rates were 50% and 91.7%, respectively, and the incidence of drug-related adverse reactions was low and mild. Conclusion Carbofen has a wide spectrum of antifungal drugs, good efficacy, little drug interaction, and good tolerance, especially for the treatment of AA with IFD.
【作者单位】：中国医学科学院北京协和医学院血液学研究所血液病医院;
【基金】：天津市青年基金资助项目(14JCQNJC10700)
【分类号】：R519;R556.5

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