伊曲康唑口服液与氟康唑预防急性白血病并粒细胞减少患者真菌感染的疗效分析

Clinical analysis on the effect of itraconazole oral solution versus fluconazole in the prevention of fungal infection in neutropenic patients with acute leukemia

目的比较伊曲康唑口服液与氟康唑预防急性白血病并粒细胞减少患者真菌感染的疗效和耐受性。方法急性白血病并粒细胞减少患者84例随机分为伊曲康唑口服液组及氟康唑组各42例,观察两组对预防真菌感染的临床效果,相关死亡率及副作用。结果 84例中可评估患者75例,39例接受氟康唑预防,10例发生真菌感染,其中侵袭性真菌感染6例;36例接受伊曲康唑口服液患者,3例发生真菌感染,均为表浅真菌感染,总感染率分别为25.6%和8.3%,伊曲康唑口服液组总真菌感染率和侵袭性真菌感染率显著低于氟康唑组;因真菌感染发生死亡患者在伊曲康唑口服液组及氟康唑组分别为1例和5例,无统计学意义。两种抗真菌药患者均可耐受。结论应用伊曲康唑口服液可预防和显著减少真菌感染,尤其是深部真菌感染率,且安全、可耐受。

Objective To compare the efficacy of intraconazole oral solution and fluconazole in preventing fungal infection in neutropenic patients with acute leukemia and the patients＇ tolerance to them.Methods 84 patients with acute leukemia of neutropenic patients were randomly assigned to receive itraconazole oral solution and fluconazole to prevent fungal infection.The rate of fungal infections,related mortality and the side effects were observed.Results 75 patients were assessed.Clinical fungal infections occurred in 10 among 39 patients in fluconazole group,and 3 among 36 patients in itraconazole oral solution group.6 patients with invasive fungal infections only occurred in fluconazole group.Overall rate of fungal infections is 25.6% and 8.3% respectively.The incidence of fungal infection and invasive fungal infections were significantly lower in the itraconazole oral solution group than in the fluconazole group.The incidence of fungal infection-related mortality wasn＇t significantly different in two groups.All patients can be tolerant of the two drugs.Conclusion Itraconazole oral solution for the prevention of fungal infection can decrease the rate of fungal infections and invasive fungal infections in neutropenic patients with acute leukemia and was tolerated.