泊沙康唑肠溶片抗真菌初级预防在血液系统恶性肿瘤化疗期间有效性与安全性分析  

Efficacy and safety analysis of posaconazole enteric-coated tablets for primary prophylaxis of fungal infections during chemotherapy for hematological malignancies

作　　者：李可芯 李晓云[1] 赵薇薇 刘瑶[1] 董秀帅[1] 刘娟[1] 王连杰[1] 陈丽艳[1] 高新宇[1] 王巍[1] LI Ke-xin;LI Xiao-yun;ZHAO Wei-wei;LIU Yao;DONG Xiu-shuai;LIU Juan;WANG Lian-jie;CHEN Li-yan;GAO Xin-yu;WANG Wei(Department of Hematology,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院血液内科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2022年第4期329-333,共5页Journal of Harbin Medical University

基　　金：湖北陈孝平科技发展基金会青年科学专项基金(CXPJJH121003-2121);哈尔滨医科大学附属第二医院中青年创新科学研究基金(YKCX2018-15);哈尔滨工业大学合作横向科研项目(JH20180176)。

摘　　要：目的研究血液系统恶性肿瘤患者化疗期间采用泊沙康唑肠溶片初级预防真菌感染的有效性和安全性。方法回顾性分析2021年8月~2022年3月哈尔滨医科大学附属第二医院接受化疗期间的145例血液系统恶性肿瘤患者资料,根据抗真菌预防药物分为泊沙康唑肠溶片预防组69例和对照组(伏立康唑预防)76例,比较两组患者疾病特征、侵袭性真菌病(invasive fungal disease,IFD)预防效果及药物不良反应。结果145例血液系统恶性肿瘤患者化疗期间,泊沙康唑肠溶片预防组1例发生IFD,发生率为1.4%,为确诊病例。对照组患者中9例发生IFD,其中确诊2例,拟诊2例,未确定5例。泊沙康唑肠溶片预防组IFD发生率低于对照组(χ^(2)=6.084,P=0.014)。泊沙康唑肠溶片预防组(11.6%)不良反应的发生率低于对照组(25.0%),差异具有统计学意义(P=0.038)。结论应用泊沙康唑肠溶片在血液系统恶性肿瘤患者化疗期间进行IFD初级预防,能够显著降低IFD的发生率,不良反应的发生率低于伏立康唑且可以耐受。Objective To study the efficacy and safety of posaconazole enteric-coated tablets for primary prevention of fungal infections in patients with hematological malignancy during chemotherapy.Methods The data of 145 patients with hematological malignancies who received chemotherapy in the Second Affiliated Hospital of Harbin Medical University from August 2021 to March 2022 were retrospectively analyzed,and they were divided into posaconazole enteric-coated tablet prevention group with 69 cases and control group(voriconazole prevention)with 76 cases according to antifungal prophylaxis.The disease characteristics,prevention effect of invasive fungal disease(IFD)and adverse drug reactions were compared between the two groups.Results During chemotherapy,1 patient developed IFD,with an incidence of 1.4%,which was a confirmed case in the posaconazole enteric-coated tablet prevention group.In the control group,9 patients developed IFD,including 2 confirmed cases,2 suspected cases,and 5 undetermined cases.The incidence of IFD in posaconazole enteric-coated tablet prevention group was lower than that in control group(χ^(2)=6.084,P=0.014).The incidence of adverse reactions in posaconazole enteric-coated tablet prevention group(11.6%)was lower than that in control group(25.0%),and the difference was statistically significant(P=0.038).Conclusion The application of posaconazole enteric-coated tablets for primary prevention of IFD in patients with hematological malignancies during chemotherapy can significantly reduce the incidence of IFD,and the incidence of adverse reactions is lower than voriconazole and can be tolerated.

关 键 词：血液系统恶性肿瘤 泊沙康唑片剂 侵袭性真菌病 预防性治疗 

分 类 号：R733[医药卫生—肿瘤]