造血干细胞移植患者预防性抗真菌治疗  

Clinical Trial of Prophylactic Antifungal Therapy in Patients Undergoing Hematopoietic Stem Cell Transplantation

作　　者：周绮[1] 楼方定[1] 张伯龙[1] 姚善谦[1] 王小沛[1] 王全顺[1] 高春记[1] 朱军[1] 

机构地区：[1]解放军总医院,北京100853

出　　处：《中华医院感染学杂志》2000年第3期177-178,共2页Chinese Journal of Nosocomiology

摘　　要：为比较抗真菌药物对造血干细胞移植患者真菌感染的预防效果。方法　对 12 8例移植患者预防应用抗真菌药物的临床疗效进行分析 ;分 3组 :酮康唑 0 .2每日 1次口服 30例 ,酮康唑 0 .2每日 1次口服 ,同时加大蒜素 2～ 3粒 ,每日 3次口服或 30～ 6 0 mg,每日 1次静脉点滴 36例 ,氟康唑 5 0～ 10 0 m g每日 1次口服 6 2例。结果　单用酮康唑组真菌感染率为 43.3% ,真菌血症 10 % ;酮康唑与大蒜素合用组真菌感染率为 47.2 % ,真菌血症为 11.1% ;氟康唑组真菌感染率为 14.5 % ,真菌血症 3.2 % ;各种念珠菌感染为首位。结论　本组患者应用氟康唑预防移植过程中真菌感染疗效优于酮康唑 ,加用大蒜素并未降低真菌感染发生率 ,各种念珠菌仍是造血干细胞移植最常见真菌感染。OBJECTIVE The effects of prophylactic antifungal therapy were retrospectively evaluated in 128 patients undergoing hematopoietic stem cell transplantation(HSCT). METHODS The patients were divided into three groups according to different drugs used,ie,ketoconazole, ketoconazole plus Allium sativum and fluconazole. RESULTS In 30 patients taking ketoconazole alone,in 13(43.3%) were found fungal infections,including 3(10%) with fungal septicemia. In 36 patients receiving besides A satirvum ketoconazole plus, fungal infection was found in 17(47.2%),including 4(11.1%) with fungal septicemia.In fluconazole group(62 patients),9(14.5%)suffered from fungal infection,2(3.2%) of which were fungal septicemia.Candidiasis was the most frequent type in fungal infection.CONCLUSIONS 1.Fluconazole has better clinical effects on prevention of fungal infection than ketoconazole.2.Prophylactic use of A sativum does not decrease fungal infection.3.Candida infection is still the most common fungal infection in patients undergoing HSCT.

关 键 词：造血干细胞移植 真菌感染 预防 治疗 

分 类 号：R457.7[医药卫生—治疗学]