造血干细胞移植后早期侵袭性真菌感染的临床分析

Clinical analysis of fungal infections in patients undergoing hemopoietic stem cell transplantation

目的:探讨更好地诊断和治疗移植后早期真菌感染。方法:分析6例异基因造血干细胞移植(HSCT)后真菌感染患者的临床特征及治疗情况,并评价疗效。结果:6例HSCT患者在移植后38～86d内发生真菌感染。6例中确诊真菌感染者2例,临床诊断2例,临床拟诊2例。病原学检测结果显示,1例确诊为中枢神经系统新型隐球菌感染,3例为念珠菌感染。6例中4例治疗有效。结论:积极预防、早期诊断及经验性或早期干预性治疗是控制HSCT后侵袭性真菌感染的关键,对提高真菌感染治疗有效率和移植后生存率具重要临床意义。

Objective To diagnose and treat fungal infections after hemopoietic stem cell transplantation（HSCT） .Methods Clinical manifestations and management results of 6 patients with fungal infection diagnosed in the early post-transplant period were analyzed.Results The 6 patients were diagnosed as fungal infection at 38-86 d after transplantation.They were all allografted.Of them,2 were proven to be infected fungus,2 were probable,and 2 were possible.The fungal pathogens proved were Candida（n=3） and Cryptococcus（n=1） .The treatment was effective in the 4 patients out of 6（66.7%） .Conclusions Early diagnosis,active prevention and empirical or early therapy are the keys to manage fungal infection and improve post-transplant survival for HSCT patients.