卡泊芬净治疗高龄患者侵袭性真菌病29例临床分析

Clinical analysis of caspofungin treatment for invasive fungal disease in advanced age patients

目的观察卡泊芬净治疗高龄患者侵袭性真菌病（IFD）的疗效和安全性。方法回顾分析我院老年病房接受过卡泊芬净治疗的IFD患者的临床资料。结果2007年1月至2009年8月共有29例患者接受卡泊芬净治疗，且均为80岁以上高龄患者。除1例于用药当天死亡外，28例可评价疗效的患者中，痊愈13例（46．4％），显效6例（21．4％），进步3例（10．8％），无效6例（21．4％），总有效率为67．8％。13例痊愈者中，12例为念珠菌菌血症患者，1例为拟诊肺白念珠菌病患者。无效6例患者中，2例为念珠菌菌血症患者，1例为拟诊肺念珠菌病患者，3例为疑诊肺IFD患者。治疗过程中1例患者出现谷丙转氨酶升高，考虑为与用药有关的肝功能受损。结论卡泊芬净是治疗高龄患者侵袭性真菌病的安全有效药物。

Objective To evaluate the efficacy and safety of easpofungin in the treatment of invasive fungal disease （IFD） in advanced age patients. Methods A retrospective analysis of the clinical data was conducted. IFD patients who had received caspofungin treatment in elderly wards were included. Results From January 2007 to August 2009, 29 IFD patients aged 80-100 years （mean 89） were treated with caspofungin. Except that one patient dead on the first drug administration day, there were 28 evaluable patients, 13 were cured （46.4%）, 6 were markedly improved （21.4%）, 3 progressed （10.8%） and 6 dead （21.4%）. The overall effective rate was 67.8%. Of 13cured patients, 12 were eandida bacreremia, 1 was eandida albicans disease of lung. Of 6 dead patients, 2 were candida bacteremia, l was candida alhieans disease of lung and 3 was suspected of lung IFD. One patient performed that alanine aminotransferase was increased, considering drug- related impairment of liver function. Conclusions Caspofungin is effective and safe in the treatment of IFD in advanced age patients.