急性白血病合并真菌血症的临床特征与防治  

Clinical character and therapy of acquired fungemia in acute leukemia patients

作　　者：董戴玉[1] 卞锦国[1] 陈洁[1] 

机构地区：[1]上海第二医科大学附属新华医院血液科,上海200092

出　　处：《中国癌症杂志》2005年第2期159-160,共2页China Oncology

摘　　要：目的:研究急性白血病获得性真菌血症的临床特点及其防治方法。方法:回顾性分析近5年来急性白血病住院患者127例中34例获得性真菌血症患者的治疗资料。结果:34例患者血培养获得真菌菌株52株,念珠菌是主要病原体,占92.4%,24例伴细菌血症,占70.6%,总病死率55.7%,真菌血症死亡率23.5%,同时伴细菌血症死亡率76.4%;氟康唑(大扶康)与两性霉素脂质体治疗有效率分别为70.8%与66.7%,两者联合治疗有效率为75%。结论:真菌感染已成为急性白血病患者死亡的原因之一,重视真菌感染的监测,及时合理的抗真菌治疗是降低急性白血病获得性真菌血症发病率和病死率的主要措施,氟康唑和两性霉素脂质体仍是治疗真菌血症的有效药物。Purpose:To study the clinical characteristics and therapy of acquired fungemia in acute leukemia patients. Methods:Retrospective analysis of the clinical characteristics and therapy of 34 acquired fungemia patients from 127 acute leukemia patients was done. Results:52 fungus strains were isolated from the blood culture of 34 acquired fungemia patients. Monilia was the main pathogen (92.4%). 24 fungemia patients also had bacteremia and the percentage was (70.6%). The overall mortality rate was 55.7% .The mortality rate of fungemia and fungemia together with bacteremia were (23.5%) and 76.4% respectively. The effective rates were 70.8% for diflucan treated group, 66.7% for the liposome treated group, and 75% for the combined treatment group respectively. Conclusions:Fungus infection has been one of the main causes of death in acute leukemia patients. So timely monitoring of the fungus infection and appropriate antifungal therapy have become the principle management to reduce the incidence rate and mortality rate of fungemia in acute leukemia patients. Diflucan and liposome are still effective antifungal drugs.

关 键 词：白血病 急性 真菌血症 

分 类 号：R733.71[医药卫生—肿瘤]