两性霉素B和伏立康唑治疗儿童急性淋巴细胞性白血病化疗期侵袭性真菌感染分析

发布时间：2018-03-07 06:05

本文选题：伏立康唑　切入点：急性淋巴细胞白血病　出处：《中国实验血液学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的:研究两性霉素B和伏立康唑治疗儿童急性淋巴细胞性白血病化疗期侵袭性真菌感染的临床效果。方法:回顾性分析2014年3月至2017年2月在我院确诊为急性淋巴细胞白血病并接受治疗的214例患者临床资料,有65例患儿在化疗期间发生侵袭性真菌感染(IFI),其中35例患儿接受伏立康唑治疗,为A组;30例患儿接受两性霉素B治疗,为B组。通过统计学分析影响IFI发生率的临床因素,并比较患儿用药8周后的治疗效果和不良反应的发生情况。结果:ALL患儿IFI发病率达到30.37%,患儿的IFI发生率与住院时间、中性粒细胞缺乏持续时间相关(P0.05)。A组与B组治疗的总有效率分别为72.28%和43.33%,2组相比差异具有统计学意义(P0.05)。伏立康唑治疗的患儿的肾功能损伤、消化功能障碍和神经毒性发生率分别为8.57%、5.71%和5.71%,明显低于两性霉素B治疗的患儿(P0.05)。A组患儿躯体健康和精力情况、情绪控制和总体健康评分指数明显高于B组患儿相应的评分指数,差异有统计学意义(P0.05)。结论:ALL患儿的IFI的发生率与患儿的住院时间、中性粒细胞水平相关,伏立康唑治疗的临床效果较好,且可降低不良反应发生率,有重要临床意义。
[Abstract]:Objective: to study the clinical effect of amphotericin B and Volconazole in the treatment of invasive fungal infection in children with acute lymphoblastic leukemia during chemotherapy. Methods: from March 2014 to February 2017, the diagnosis of acute fungal infection in our hospital was analyzed retrospectively. Clinical data of 214 patients with lymphoblastic leukemia, 65 cases of invasive fungal infection occurred during chemotherapy, among which 35 cases were treated with fulconazole, 30 cases of group A received amphotericin B, group B. the clinical factors influencing the incidence of IFI were analyzed statistically. Results the incidence of IFI was 30.37%, the incidence rate of IFI and hospital stay was 30.37%, the incidence of IFI and hospitalization time of the children were compared after 8 weeks of treatment. The total effective rates of neutrophil deficiency in group A and group B were 72.28% and 43.33, respectively. There was significant difference between group A and group B (P 0.05). The incidence of digestive dysfunction and neurotoxicity were 8.57% and 5.71%, respectively, which were significantly lower than those of amphotericin B group (P 0.05). The scores of mood control and general health were significantly higher than those of group B. Conclusion the incidence of IFI is related to the length of stay and neutrophil level in the children with all. The clinical effect of the treatment with volconazole is better and the incidence of adverse reactions can be reduced, which is of great clinical significance.
【作者单位】：贵州省儿童医院遵义医学院附属医院儿内二科;
【分类号】：R733.71

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