伏立康唑治疗儿童血液病合并侵袭性肺曲霉菌感染的临床分析  

Clinical analysis of voriconazole in treatment of invasive pulmonary aspergillosis in children with hematological disease

作　　者：周海霞[1] 李原[1] 钱江潮[1] 王菊香[1] 方希敏[1] 黄珍[1] 曾炜炜[1] 陈敏[1] 徐智胜[1] 

机构地区：[1]温州医学院附属第二医院儿童血液科,浙江温州325000

出　　处：《中华医院感染学杂志》2012年第16期3627-3629,共3页Chinese Journal of Nosocomiology

摘　　要：目的观察伏立康唑治疗儿童血液病合并侵袭性肺曲霉菌感染(IPA)的临床疗效及安全性。方法回顾性分析医院2009年2月-2011年7月血液病伴发侵袭性肺曲霉菌感染住院患儿10例,所有患儿均经CT检查和GM试验临床诊断;伏立康唑针每次7mg/kg,静脉滴注,1次/12h,10～14d后改用伏立康唑片剂,剂量不变,口服1次/12h,总疗程4～8周;根据临床疗效标准,综合评价该药物的疗效和安全性。结果 10例患儿中,9例治疗有效,总有效率为90.0%,治疗有效的9例患儿从症状及体征上判定临床有效的时间为2～5d;伏立康唑治疗过程中两例发生轻微不良反应,不良反应发生率20.0%。结论伏立康唑口服和静脉给药均有很好的抗真菌活性,可作为儿童血液病伴发肺曲霉菌感染的一线用药,高效而安全。OBJECTIVE To evaluate the clinical efficacy and safety of vorieonazole in the treatment of invasive pulmonary aspergillosis in the children with hematological disease. METHODS A total of 10 children with invasive pulmonary aspergillosis complicated by hematological disease who enrolled the hospital from Feb 2009 to Jun 2011 were analyzed respectively, the diagnosis was confirmed by CT and GM test. All of them were treated with intravenous voriconazole 7 mg/kg, once per 12 hours lasting for about 10- 14 days before changing to oral maintenance therapy of the same dosage for 4--8 weeks. The efficacy and safety of voriconazole; were comprehensively evaluated according to clinical evaluation criteria. RESULTS The overall response rate of the 10 patients was 90.0% （9 of 10） after voriconazole treatment; the clinical effective time was 2--5 days by judging from the symptoms and physical condition of the 9 patients; the incidence of drug related adverse events was 20.0%. CONCLUSION Both the oral and intravenous use of voriconazole show good antifungal activity, which therefore can be used as the first-line antibiotics for the treatment of pulmonary aspergillosis in the children with hematological disease.

关 键 词：伏立康唑 儿童血液病 侵袭性肺曲霉菌病 感染 

分 类 号：R978.1[医药卫生—药品]