伊曲康唑预防血液肿瘤患者粒细胞减少期并发真菌感染的疗效观察

Clinical observation on itraconazole for prophylaxis of fungal infection in neutropenic patients with hematological malignancy

目的:探究应用伊曲康唑口服液预防血液肿瘤患者化疗后粒细胞减少期并发真菌感染的效果。方法:将62例化疗后中性粒细胞减少的血液肿瘤患者随机分为真菌感染预防用药组和对照组,其中预防用药组患者预防性地服用伊曲康唑口服液,而对照组患者未接受任何预防性抗真菌药物治疗。观察并比较2组患者真菌感染的发生率和严重程度。结果:31例服用伊曲康唑口服液患者中,仅2例发生真菌感染,真菌感染率仅为6.5%,而对照组31例中,8例并发真菌感染,包括3例深部真菌感染,真菌感染率为25.8%,明显高于预防用药组(P<0.01),而且2组患者并发真菌感染的病原菌存在明显差异。结论:预防性应用伊曲康唑口服液能有效降低血液肿瘤患者化疗后粒细胞减少期真菌感染的概率。

Objective：To investigate the efficacy of itraconazole oral solution for prophylaxis of fungal infection in neutropenic patients with hematological malignancy after chemotherapy. Method： 62 neutropenic patients with hematological malignancy after chemotherapy were randomly divided into fungal prophylaxis and control group. The patients in prophylactic group received itraconazole oral solution, while no antifungal agent was used in con- trol group. The incidence and severity of fungal infection was statistically compared between two groups. Result： Among 31 patients receiving prophylactic administration of itraconazole oral solution, only two patients with fungal infection were documented. In the control group, 8 patients suffered from fungal infection including 3 cases with deep fungal infection. The incidence of fungal infection was significantly higher in the control group than in the itraconazole prophylaxis group, （25.8% versus 6.5%, P 〈0. 01）. Moreover, there were significant intergroup differences in pathogens identified in patients with fungal infection. Conclusion： Prophylactic administration of itraconazole oral solution could effectively reduce fungal infection in patients with hematological malignancy during neutropenic period following chemotherapy.