造血干细胞移植中氟康唑与伊曲康唑短疗程预防真菌感染的观察

Effect of short course treatment of fluconazole and itraconazole in preventing invasive fungal infection in patients after allogeneic hematopoietic stem cell transplantation

目的比较异基因造血干细胞移植患者应用氟康唑和伊曲康唑预防侵袭性真菌感染的疗效及安全性。方法回顾分析192例异基因造血干细胞移植患者予短疗程(30d)氟康唑或伊曲康唑行真菌一级预防,其中应用氟康唑134例,伊曲康唑58例,比较两组患者侵袭性真菌感染的发生和转归情况。结果氟康唑组和伊曲康唑组移植30、60、90、180d侵袭性真菌感染的发生率分别为9.0%和5.2%、16.5%和6.9%、17.2%和8.7%、22.0%和16.4%,差异均无统计学意义(P值分别为0.370、0.081、0.128、0.309),但移植后60d时P值明显较小。真菌感染发生部位均以肺部为主。患者均能很好耐受两药,但伊曲康唑副反应较大(19.0%vs2.2%,P=0.000)。结论短疗程伊曲康唑与氟康唑预防异基因造血干细胞移植后侵袭性真菌感染在移植60d时伊曲康唑较氟康唑显示了一定的优势。

Objective To compare the effeciency of fluconazole and itraconazole in preventing invasive fungal infection in patients after allogeneic hematopoietic stem cell transplantation. Methods 192 cases were divided into fluconazole group consisted of 134 patients and itraconazole group consisted of 58 patients.The occurrence and prognosis of invasive fungal infection between the two groups were compared. Results The incidence rates of invasive fungal infection in fluconazole and itraconazole group were respectively 9.0% and 5.2% ,16.5% and 6.9% ,17.2% and 8.7% ,22% and 16.4% at 30days, 60days, 90days and 180days after transplantation （P=0.370,0.081,0.128 and 0.309, respectively）.There are more side effects in patients ~iven itraconazole. Conclusion Itraconazole annear to manife^st certain ~un^rinrltv At 60 claw After/rAn^r~l^nt^tlnn