卡泊芬净联合其他抗真菌药物治疗恶性血液病患者中性粒细胞缺乏合并侵袭性真菌感染的有效性和安全性探讨  

Effectiveness and safety of caspofungin combined with other antifungal agents in the treatment of neutropenia with invasive fungal infection in patients with hematologic malignancies

作　　者：杨爱英[1] 马力[1] 迟晓盟 YANG Ai-ying;MA Li;CHI Xiao-meng(Department of Hematology,Dalian Friendship Hospital,Dalian 116001,China)

机构地区：[1]大连市友谊医院血液内科,116001

出　　处：《中国现代药物应用》2023年第9期125-127,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨卡泊芬净联合其他抗真菌药物治疗恶性血液病患者中性粒细胞缺乏合并侵袭性真菌感染的有效性和安全性。方法60例恶性血液病中性粒细胞缺乏合并侵袭性真菌感染患者,采用卡泊芬净联合其他抗真菌药物治疗。分析患者的临床资料[基础疾病治疗方式、是否首选、感染部位、可疑感染部位病原菌(曲霉属)]、治疗效果、卡泊芬净不良反应发生情况及临床表现。结果60例患者中保守治疗10例,化疗及其他治疗50例;首选35例,其他药物治疗后换用25例;肺部感染32例,其他部位感染28例;感染部位病原菌(曲霉属)阳性38例,阴性22例。60例患者治疗显效50例,显效率为83.33%。60例患者中29例发生不良反应,不良反应发生率为48.33%(29/60),其中消化系统不良反应6例,代谢和营养异常7例,泌尿系统不良反应6例,输液反应5例,皮肤不良反应5例。患者不良反应程度比较轻,经有效治疗后,均有好转。结论采用卡泊芬净联合其他抗真菌药物对恶性血液病患者中性粒细胞缺乏合并侵袭性真菌感染进行治疗,有效性和安全性比较高,可推广。Objective To discuss the effectiveness and safety of caspofungin combined with other antifungal agents in the treatment of neutropenia with invasive fungal infection in patients with hematologic malignancies.Methods 60 cases of hematologic malignancies patients with neutropenia and invasive fungal infection were treated with caspofungin in combination with other antifungal agents.The clinical data[underlying disease treatment modality,whether preferred,infection site,suspected infection site pathogen(Aspergillus spp.)],therapeutic effect,occurrence of adverse reactions of caspofungin,and clinical manifestations of the patients were analyzed.Results Among the 60 patients,10 cases were treated conservatively and 50 cases were treated with chemotherapy or other treatments.35 cases preferred caspofungin,25 cases were switched to other drugs after treatment;32 cases of pulmonary infection and 28 cases of other sites infection.The pathogenic bacteria(Aspergillus)at the infection site were positive in 38 cases and negative in 22 cases.50 out of 60 patients were effective,with a significant efficiency of 83.33%.29 out of 60 patients had adverse reactions,the incidence of adverse reactions was 48.33%(29/60),including 6 cases of digestive system adverse reactions,7 cases of abnormal metabolism and nutrition,6 cases of urinary system adverse reactions,5 cases of infusion reactions,and 5 cases of skin adverse reactions.The adverse reactions in patients was relatively mild,and all of them improved after effective treatment.Conclusion The use of caspofungin in combination with other antifungal gents for the treatment of neutropenia with invasive fungal infection in patients with hematologic malignancies is relatively effective and safe,and can be promoted.

关 键 词：卡泊芬净 抗真菌药物 恶性血液病 中性粒细胞缺乏 侵袭性真菌感染 

分 类 号：R733[医药卫生—肿瘤]