急性白血病患者应用抗真菌药物预防侵袭性真菌病的疗效与安全性分析

发布时间：2018-08-19 12:32

【摘要】：目的评价抗真菌药物对预防粒细胞缺乏急性白血病患者侵袭性真菌病(IFD)的疗效及安全性,为临床选择预防真菌感染药物提供依据。方法回顾性分析2008年6月-2015年6月急性白血病化疗后粒细胞缺乏期7d的患者临床资料,共统计392例患者,将其分为预防组239例(包括氟康唑组133例、伏立康唑组106例),对照组153例;统计各组IFD发生率、病死率和抗真菌药物不良反应,数据采用SPSS 17.0软件进行统计分析。结果 IFD发生率对照组为37.9%、氟康唑组为22.6%、伏立康唑组为10.4%;对照组与氟康唑组和伏立康唑组IFD发生率比较,差异均有统计学意义(P0.05);患者IFD病死率对照组为10.5%、氟康唑组为6.8%、伏立康唑组为4.7%,对照组与氟康唑组和伏立康唑组的病死率差异均有统计学意义(P0.05);氟康唑组与伏立康唑组患者不良反应发生率比较,差异无统计学意义。结论在急性白血病大剂量化疗中性粒细胞缺乏7d时预防应用抗真菌药物可以有效降低IFD的发生及病死率,在急性白血病患者诱导化疗时选择伏立康唑进行真菌预防,疗效和安全性均较好。
[Abstract]:Objective to evaluate the efficacy and safety of antifungal drugs in the prevention of invasive mycosis (IFD) in patients with acute myelocytic leukemia. Methods the clinical data of 392 patients with acute leukemia during 7 days after chemotherapy were retrospectively analyzed. The patients were divided into two groups: 239 patients in the prevention group (including 133 patients in the fluconazole group). The incidence of IFD, mortality and adverse drug reactions of antifungal drugs in each group were analyzed by SPSS 17.0 software. Results the incidence of IFD was 37.9 in control group, 22.6in fluconazole group and 10.4 in fulconazole group, and the incidence of IFD in control group was higher than that in fluconazole group and vermiconazole group. The mortality of patients with IFD was 10.5 in the control group, 6.8 in the fluconazole group and 4.7 in the voriconazole group. The mortality of the control group was significantly different from that of fluconazole group and voleconazole group (P0.05), and the mortality of fluconazole group and voleconazole group was significantly higher than that of fluconazole group (P0.05). Comparison of the incidence of adverse reactions in the zolium group, The difference was not statistically significant. Conclusion prophylactic application of antifungal drugs on 7 days after high dose chemotherapy of neutrophil deficiency in acute leukemia can effectively reduce the incidence and mortality of IFD. The curative effect and safety are good.
【作者单位】：天津市第一中心医院血液科;天津市第一中心医院感染科;
【基金】：天津市卫生行业科技攻关基金资助项目(15KG135,13KG106) 天津市卫生局基金资助项目(2012KZ022)
【分类号】：R733.71;R519

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