伏立康唑治疗非移植血液系统疾病合并侵袭性真菌感染的临床分析

Clinical analysis of voriconazole in treatment of invasive fungal infections in patients with non-transplantation hematological disease

目的观察伏立康唑治疗非移植血液系统疾病患者合并侵袭性真菌感染(IFI)的疗效及安全性。方法对2005年1月-2010年12月在中山大学附属第一医院住院,首次使用伏立康唑单药治疗IFI的156例血液病患者疗效及不良反应进行回顾性分析。结果 148例患者(94.9%)为单一部位感染,以肺部(77.7%)最为常见,另有8例患者为播散性真菌感染;76.9%的患者存在≥2个高危因素;确诊4例(2.6%),临床诊断45例(28.8%),拟诊107例(68.6%);临床诊断和确诊患者有效率为59.2%;拟诊患者中治疗成功率为78.5%;开始治疗后6周生存率为85.9%,12周生存率为80.8%;停药率为3.2%。结论伏立康唑治疗血液系统疾病合并侵袭性真菌感染有效率高,耐受性良好。

OBJECTIVE To observe the efficacy and safety of voriconazole for invasive fungal infection （IFI） in patients with non-transplantation hematological diseases. METHODS A total of 156 hospitalized patients with non- transplantation hematological diseases who were treated with voriconazole for IFI from Jan 2005 to Dec 2010 in the First Affiliated Hospital of Sun Yat-sen University were collected, and the clinical efficacy and the adverse reactions were retrospectively analyzed. RESULTS There were 148 （ 94.9 %） patients with one-site infections, the pulmonary infections were the most common, accounting for 77. 7%, and there were 8 cases of patients with disseminated infections; there were more than 2 high risk factors for 76.9% of the patients; 4 （2.6%） cases were conformed, 45 （28.8%） cases were clinically diagnosed, and 107 （68. 6%） cases were suspected; the effective rate of the clinically diagnosed and confirmed patients was 59.2%; the success of the treatment was achieved in 78.5% of the suspected cases; the total survival rate of 6 weeks after the treatment was 85.9%, 80.8% of 12 weeks after the treatment; the rate of drug withdrawal was 3.2%. CONCLUSION Voriconazole is effective and safe in the treatment of IFI in the patients with non--transplantation hematological disease.