伏立康唑在急性髓系白血病真菌感染二级预防中的应用  

Voriconazole in secondary prophylaxis of fungal infections in patients with acute myeloid leukemia

作　　者：赵邢力 李巍 林冬 刘兵城 周春林 王津雨 宫本法 刘凯奇 魏述宁 张广吉 秘营昌 王建祥 

机构地区：[1]中国医学科学院血液病研究 所北京协和医学院 血液病医院白血病诊疗中心,天津300020 [2]中国医学科学院血液病研究所 北京协和医学院 血液病医院白血病诊疗中心,天津300020

出　　处：《中华医院感染学杂志》2012年第11期2401-2403,共3页Chinese Journal of Nosocomiology

摘　　要：目的评价伏立康唑在急性髓系白血病(AML)化疗中真菌感染二级预防中的有效性与安全性。方法收集医院2009年6月-2011年8月的38例既往侵袭性肺真菌感染的AML患者,再次化疗后应用伏立康唑片进行二级预防,按照开始预防时间分为中性粒细胞>1×109/L和中性粒细胞<1×109/L两组,总结分析预防用药的疗效及不良反应。结果应用伏立康唑片进行真菌感染的二级预防,未发现严重的不良反应,整体预防失败的比例为10.5%,中性粒细胞>1×109/L开始预防的患者无预防失败发生,中性粒细胞<1×109/L开始预防的患者,预防失败者占18.2%。结论应用伏立康唑片进行真菌感染的二级预防具有较好的安全性和耐受性,并有可能降低真菌感染的复发,在中性粒细胞>1×109/L开始二级预防,可以提高二级预防的成功率。OBJECTIVE To evaluate the safety and efficacy of voriconazole in secondary prophylaxis of fungal infections in the acute myeloid leukemia（AML）patients.METHODS A total of 38 AML patients with invasive pulmonary fungal infections who enrolled in hospital from Jun 2009 to Aug 2011 were involved in this research.Secondary prophylaxis with voriconazole was performed after the chemotherapy,by referring to the starting time of the prophylaxis,the patients were divided into the group with neutrophils counts more than 1×10^9/L and the neutrophils counts less than 1×10^9/L;the efficacy of prophylactic antibiotics and the adverse reactions were summarized and analyzed;the patients with failed prevention accounted for 18.2%.RESULTS No serious adverse reactions were found during the secondary antifungal prophylaxis with voriconazole,the proportion of overall failure of prophylaxis was 10.5%,no reactivation was found in the group that started the secondary antifungal prophylaxis as the neutrophils counts was more than 1×10^9/L,the reactivation was found in the group that started the secondary antifungal prophylaxis as the neutrophils counts was less than 1×10^9/L.CONCLUSION Voriconazole is with preferred safety and tolerance in the secondary prophylaxis of fungal infections,which can decrease the reoccurrence of fungal infections as well as raise the success rate of secondary prophylaxis as the secondary prophylaxis starts when the neutrophils counts is more than 1×10^9/L.

关 键 词：真菌 急性髓系白血病 伏立康唑 二级预防 

分 类 号：R978.5[医药卫生—药品]