氟康唑一级预防异基因造血干细胞移植后侵袭性真菌病的临床观察  

Clinical observation of fluconazole on primary prevention in invasive fungal disease after allogeneic hematopoietic stem cell transplantation

作　　者：吴远彬[1] 王国征[1] 李琤[1] 李慧[1] 陈瑶[1] 胡永珍[1] 刘阳[1] 代喜平[1] WU Yuan-bin;WANG Guo-zheng;LI Cheng;LI Hui;CHEN Yao;HU Yong-zhen;LIU Yang;DAI Xi-ping(Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广东省中医院,广州510120

出　　处：《内科急危重症杂志》2018年第4期289-292,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨应用氟康唑一级预防异基因造血干细胞移植(allo-HSCT)后侵袭性真菌病(IFD)的疗效及其高危因素。方法:回顾性分析使用氟康唑一级预防IFD的79例患者,评估其疗效并分析其高危因素。结果:中位随访31(3～60)个月,79例患者在移植后1年内有14例(17. 72%)发生IFD,中位发生时间为+53d(+8～+268 d)。移植后1、3及12个月的累积发病率分别为1. 27%、10. 10%和17. 72%。多因素分析显示,合并严重移植物抗宿主病(GVHD)、大剂量糖皮质激素的应用为氟康唑一级预防后IFD突破的高危因素。结论:氟康唑是allo-HSCT患者IFD一级预防的有效药物,合并GVHD、大剂量糖皮质激素的应用为氟康唑一级预防后IFD突破的高危因素。Objective： To study the efficacy and risk factor of fluconazole on primary prevention in invasive fungal disease（ IFD） after allogeneic hematopoietic stem cell transplantation（ allo-HSCT）. Methods： Seventy-nine patients undergoing HSCT were analyzed retrospectively. The incidence and risk factors of IFD were evaluated. Results： Of the total 79 patients,14（ 17. 72%） was proven IFD within one year after allo-HSCT. The infection occurred a median of 53 days after HSCT and the cumulative incidence of IFD in 1 month,3 months and one year was 1. 27%,10. 10%,and 17. 72% respectively. The multivariate analysis revealed that severe graft-versus-host disease（ GVHD） and glucocorticosteroid use were the high risks of IFD following fluconazole on primary prevention. Conclusions： Fluconazole on primary prevention for IFD after allo-HSCT is effective. Severe GVHD and glucocorticosteroid use were the high risks of IFD following fluconazole on primary prevention.

关 键 词：氟康唑 造血干细胞移植 侵袭性真菌病 一级预防 

分 类 号：R551.3[医药卫生—血液循环系统疾病]