伊曲康唑序贯治疗恶性血液病合并侵袭性真菌感染的疗效分析

Efficacy of Itraconazole on Invasive Fungal Infections with Malignant Hematologic diseases

目的分析伊曲康唑序贯治疗恶性血液病合并侵袭性真菌感染(IFI)的疗效及安全性。方法应用伊曲康唑序贯治疗47例恶性血液病合并IFI患者,观察其有效率、退热率、肺部影像学表现及毒副反应。结果伊曲康唑序贯治疗恶性血液病合并IFI的总有效率为61.7%,临床诊断、拟诊病例的有效率分别为64.3%、62.5%;其中发热患者35例,退热率77.1%;肺部CT表现阳性者43例,炎症较前吸收者占67.4%。毒副反应主要为低钾血症、肝损伤、黄疸、恶心、味觉异常、寒战。结论伊曲康唑序贯治疗恶性血液病合并IFI疗效确切,安全性好,可作为抢先治疗和经验治疗的选择。

Objective To analyze the efficacy and safety in the treatment of invasive fungal infections （IFI） with malignant hematologic diseases. Methods Itraconazole was used in treatment of IFI in the 47 patients with hematologic diseases, and the efficacy, the rate of bringing down a fever, the lung imaging and the toxicities were observed. Results The overall effective rate of itraconazole was 61.7%. The effective rates of probable and possible patients were 64.3% and 62.5% respectively. There were 35 cases with fever,the rate of bringing down a fever was 77. 1%. There were 43 cases with positive lung imaging,the rate of inflammation absorption was 67.4%. The toxieities were mainly hypokalemia,liver injury ,jaundice, nausea, parageusia and chill. Conclusion Itraconazole is effective and safe in the treatment of IFI with hematologic diseases, it can be a choice for preemptive and empirical antifungal therapy.