59例恶性血液病患者合并侵袭性真菌病的临床分析  

Clinical analysis of patients with malignant hematological diseases combined with invasive fungal infection in 59 cases

作　　者：熊丹[1] 李末娟 吴东红[1] 何红华[1] 

机构地区：[1]广东医学院附属医院血液内科,广东湛江524000 [2]广东省湛江市第二人民医院,广东湛江524000

出　　处：《中国医药科学》2016年第5期18-21,25,共5页China Medicine And Pharmacy

基　　金：广东省湛江市非资助科技攻关计划项目(2015B01097)

摘　　要：目的观察59例恶性血液病合并侵袭性真菌病患者的临床特征,并探讨两性霉素B脂质体联合伏立康唑治疗恶性血液病患者合并侵袭性真菌病的临床疗效及安全性。方法回顾性分析2010年至2015年入住我院血液科合并侵袭性真菌病(IFI)的恶性血液病患者59例的病例资料,依据使用抗真菌药物的不同进行分组,其中17例应用两性霉素B脂质体联合伏立康唑治疗(联合治疗组),24例单用伏立康唑治疗(伏立康唑组),18例单用两性霉素B脂质体治疗(两性霉素B脂质体组)。收集、总结临床特征、分析其治疗效果及安全性,并进行统计学分析。结果联合治疗组的有效率为82.3%,伏立康唑组的有效率为37.5%,两性霉素B脂质体组的有效率为61.1%。三组之间治疗有效率差异均有统计学意义(P<0.05)。而联合治疗组的不良反应发生率为58.8%,伏立康唑组的不良反应发生率为25.0%,两性霉素B脂质体组的不良反应发生率为55.5%。结论应用两性霉素B脂质体联合伏立康唑治疗恶性血液病合并侵袭性真菌病的效果较单用伏立康唑或单用两性霉素B脂质体,可明显提高疗效,且安全性上并不比单用两性霉素B脂质体差,患者往往能够耐受。Objective To observe the clinical characteristics of 59 patients with malignant hematological diseases combined with invasive fungal infection（IFI） and to explore the clinical curative effect and safety of amphotericin B liposome combined with and voriconazole in treatment of malignant hematological diseases combined with invasive fungal infection. Methods Data of 59 patients with malignant hematological diseases combined with invasive fungal infection（IFI） who were hospitalized in department of hematology of our hospital from January 2010 and June 2015 were retrospectively analyzed. They were allocated to different groups according to antifungal agents. 17 patients were treated by amphotericin B liposome combined with and voriconazole（combined treatment group）, 24 patients were treated by voriconazole（voriconazole group） and 28 patients were treated by amphotericin B liposome（amphotericin B liposome）. Clinical characteristics were collected and summarized and the curative effect and safety were analyzed by statistics. Results Effective rates of the combined treatment group, voriconazole group and amphotericin B liposome were 82.3%, 37.5% and 61.1% respectively. Differences in effective rates of three groups were statistically significant（P〈0.05）. Incidences of adverse reactions the combined treatment group, voriconazole group and amphotericin B liposome were 58.8%, 25% and 55.5% respectively. Conclusion Curative effect of amphotericin B liposome combined with voriconazole in treatment of malignant hematological diseases combined with invasive fungal infection is better than single use of amphotericin B liposome or voriconazole. And safety of combined medication is equal to the single use of amphotericin B liposome. Patients with combined medication are often tolerated.

关 键 词：恶性血液病 侵袭性真菌病 两性霉素B脂质体 联合治疗 

分 类 号：R733[医药卫生—肿瘤] R519[医药卫生—临床医学]