恶性血液病患者侵袭性肺部真菌感染的临床特点与治疗研究  

Clinical features and therapeutic measures of patients with hematologic malignancies complicated by pulmonary fungal infections during neutropenic phase after chemotherapy

作　　者：黄琰[1] 吴隼[1] 张媛[1] 字友梅[1] 杨满[1] 郭燕[1] 贺立山[1] 

机构地区：[1]新乡医学院第一附属医院血液科,河南卫辉453100

出　　处：《中华医院感染学杂志》2016年第7期1536-1538,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅基金资助项目(2006320039)

摘　　要：目的分析恶性血液病患者化疗后粒细胞缺乏期并发侵袭性肺部真菌感染的临床特点及治疗措施,为临床救治提供参考依据。方法回顾性分析2011年2月-2014年5月医院治疗的97例恶性血液病化疗后粒细胞缺乏期侵袭性肺部真菌感染患者临床资料,分析病原菌分布及治疗效果,数据采用SPSS 17.0软件进行统计分析。结果 97例肺部真菌感染患者共分离出真菌97株,主要为曲霉菌属和假丝酵母菌属,分别占28.87%和67.01%;治疗后总有效率为79.38%,死亡20例,病死率20.62%。结论恶性血液病化疗后粒细胞缺乏期侵袭性肺部真菌感染的临床特点不典型,但存在多种危险因素,有助于早期开展经验型用药,此期感染以假丝酵母菌属和曲霉菌属感染较高,目前药物治疗效果差,氟康唑、伊曲康唑、卡泊芬净、两性霉素B还需要配合使用。OBJECTIVE To analyze clinical features of patients with hematologic malignancies complicated with pulmonary fungal infections during neutropenic phase after chemotherapy and to review the therapeutic measures,in order to provide reference for clinical treatment.METHODS The clinical date of 97 cases of patients with hematologic malignancies complicated with pulmonary fungal infections during neutropenic phase after chemotherapy in hospital in Feb.2011 to May 2014 were retrospectively analyzed,and the pathogen distribution and therapeutic effects were analyzed.The software SPSS 17.0 was used for statistical analysis.RESULTS Totally 97 fungal strains were isolated from the 97 patients with pulmonary fungal infections,including Aspergillus（28.87%）and Candida albican（67.01%）.The total efficiency was 79.38%,there were 20 cases of death cases,and the mortality rate was 20.62%.CONCLUSION Clinical features of patients with hematologic malignancies complicated with pulmonary fungal infections during neutropenic phase after chemotherapy are not obvious,but there are many risk factors that may contribute to the early development of empirical medication.Infections in this period are mainly caused by C.albicanand Aspergillus.The effect of current medicine treatment is poor.Fluconazole,itraconazole,caspofungin and amphotericin B are needed to be used cooperatively.

关 键 词：恶性血液病 化疗 粒细胞减少 肺部真菌感染 

分 类 号：R733[医药卫生—肿瘤]