伊曲康唑在异基因造血干细胞移植真菌感染预防中的应用

Itraconazole application for prevention of fungal infection in patients receiving allogeneic hematopoietic stem cell transplants

目的探讨伊曲康唑在异基因造血干细胞移植患者侵袭性真菌感染预防中的疗效。方法 110例异基因造血干细胞移植患者,预防性应用伊曲康唑或氟康唑,观察两组患者发生侵袭性真菌感染的情况。结果随访至造血干细胞移植后180d,伊曲康唑组和氟康唑组侵袭性真菌感染的发生率分别为7.2%(5/69)和19.5%(8/41),二者差异有统计学意义(P<0.05);两组真菌感染相关病死率(2.9%vs.7.3%)差异无统计学意义(P>0.05);伊曲康唑的不良反应发生率较氟康唑高(26.9%vs.7.0%),但患者均能耐受。结论伊曲康唑预防用药可以显著降低异基因造血干细胞移植患者侵袭性真菌感染的发生率,是一种安全、有效的方法。

Objective To evaluate the clinical effect of itraconazole in prevention of invasive fungal infections in allogeneic hema- topoietic stem cell transplantion. Methods In this retrospective study, 110 patients receiving allogeneic hematopoietic stem cell transplants were administed itraconazole or fluconazole for prevention of fungal infection. The occurrence and prognosis of invasive fungal infection,and the side effect of both pyrroles were observed. Results Proven and probable invasive fungal infections occurred in 5 of 69 itraconazole recipients（7.2%） and in 8 of 41 fluconazole recipients（19.5 %） during the first 180 days after transplantation, the difference had statistical significance（P〈0.05）. The fatality rate related to fungal infection had no statistical difference between the two groups（2.9 % vs. 7.3 %）. The occurrence of itraconazole adverse reactions were more than fluconazole（26.9 % vs. 7.0%） ,and both itraconazole and flueonazole were well tolerated. Conclusion Itraconazole significantly reduces the incidence of invasive fungal infection in the patients receiving allogeneic hematopoietic stem cell transplants, and it is a effective and safe prophylaxis.