伏立康唑+卡泊芬净联合治疗血液病患者侵袭性肺部曲霉菌属感染

Treatment of Invasive Pulmonary Aspergillosis with Combination of Caspofungin and Voriconazole

目的了解应用伏立康唑＋卡泊芬净联合治疗侵袭性肺部曲霉菌属感染的疗效及安全性。方法诊断侵袭性肺部曲霉菌属感染的患者,给予伏立康唑＋卡泊芬净联合治疗7-10 d,然后根据疗效决定序贯口服伏立康唑治疗还是换用其他药物。结果 7例临床诊断和1例拟诊为侵袭性肺部曲霉菌属感染的患者,经联合抗曲霉菌属治疗后7例有效,1例无效;8例患者均能耐受伏立康唑＋卡泊芬净联合用药。结论卡泊芬净＋伏立康唑联合治疗恶性血液病患者侵袭性肺部曲霉菌属感染,是安全有效的治疗选择。

OBJECTIVE To observe the efficacy and safety of the treatment with combination of caspofungin and voriconazole in hematological patients complicated with invasive pulmonary aspergillosis.METHODS After diagnosed as invasive pulmonary aspergillosis,the patients were treated with the combination of caspofungin and voriconazole for 7 to 10 days,and then the treatment effect was evaluated.If the patients had response to the combination therapy,the combination regimen would continue for about 10 to 14 days in all,and then change to voriconazole by orally.The therapy regimen would be changed to other drugs if the patients had no response to the combination therapy.RESULTS Eight patients with hematological diseases were diagnosed as invasive pulmonary aspergillosis and received caspofungin and voriconazole combination therapy.Five patients achieved partial response,and two patients were stable and one patient became progressive after the combination treatment for 7 to 10 days.After treatment for 1 month,5 patients got complete response,and 2 patients got partial response.CONCLUSIONS The combination therapy of caspofungin and voriconazole for invasive pulmonary aspergillosis is safe and effective.