血液系统疾病合并肺部真菌感染97例临床分析

Clinical analysis of hematologic diseases complicated by pulmonary fungal infection

目的分析血液系统疾病合并真菌感染的临床特点、易感因素及探讨防治策略。方法对2001年1月至2006年12月上海交通大学医学院附属新华医院收治的97例血液病患者合并肺部真菌感染情况进行回顾性分析。结果97例患者真菌培养获得真菌201株,其中念珠菌147株,占73.1%;17.5%为两种真菌感染,71.8%伴细菌感染;相关病死率为23.7%。二性霉素B脂质体与伊曲康唑对血液病合并肺部真菌感染患者有效率分别为66.7%和63.6%。结论真菌感染是血液系统疾病继发感染的主要病原体之一,早期诊断与治疗是病情缓解与长期生存的关键。二性霉素B脂质体与伊曲康唑是治疗真菌感染的常用的有效药物。

Objective To analyse the clinical features, predisposing risk factors and treatment of hematologic diseases complicated by pulmonary fungal infection（PFI）. Methods The medical records of 97 cases of PFI were retrospectively analyzed. Results Totally 201 fungal strains were obtained from 97 cases of hematologic diseases. The candida strains were 147（73. 1% ）. Two-fungal infection was 17.5% , and secondary bacterial infection was 71.8% ;relative death rate was 23.4%. Cure rate of Amphotericln B deoxycholate and Itraconazole was 67.7% and 63.7%. Conclusion Fungal infection is one of the main pathogens in hematologic diseases complicated by infection. Early diagnosis and treatment is the key to beneficial release and long time survival. Amphotericin B deoxycholate and hraconazole were effective medicines for treated fungal infection.