伏立康唑治疗血液病并发肺部侵袭性真菌感染13例

Clinical analysis of Voriconazole in the treatmen t of invasive fungal infections of the patients with blood diseases

目的观察探讨伏立康唑治疗血液系统疾病并发肺部侵袭性真菌感染的效果及不良反应。方法回顾性分析13例血液系统疾病合并肺部侵袭性真菌感染患者的临床资料,7例患者初治即使用常规剂量伏立康唑,5例在氟康唑无效情况下改用伏立康唑,1例患者联合使用卡泊芬净及伏立康唑。结果 13例患者有效10例(其中治愈7例,改善3例),无效2例,死亡1例。副反应:肝功能异常2例,1例为谷丙转氨酶及谷氨酰转肽酶轻度升高,1例出现轻度黄疸,2例出现一过性低钾血症,未出现一次性视觉障碍,不需要停止伏立康唑进行治疗。肺部侵袭性真菌感染患者有效率为76.9%。结论伏立康唑治疗血液系统疾病并发肺部侵袭性真菌感染安全有效,副作用小。

Objective To investigate the efficacy and adverse effects of Voriconazole in the treatment of invasive fungal infections（IFI） of the patients with blood diseases.Methods The clinical manifestations and treatment of 13 cases of IFI patients with blood diseases were retrospectively analyzed.7 cases were used Voriconazole initially,5 cases used Voriconazole when Fluconazol was inefficient.1 case used Caspofungin and Voriconazole together.Results 9 cases was effective（cured 7,improved 3）,3 cases was ineffective,1 case died.Adverse effects associated with Voriconazole were significant transaminitis,2 cases occured dverse reaction,one showed GPT and GTP setting up slightly,the other showed jaundice slightly,2 cases were transient kaliopenia.Transient ocular toxicity did not happened,It was not necessary to stop Voriconazole for reducing those adverse effects.The efficacy on invasive fungal infections of the patients with blood diseases was 76.9%.Conclusion Voriconazole is effective and safe in the treatment of IFI with blood diseases.