伏立康唑与两性霉素B治疗急性淋巴细胞白血病真菌感染的临床疗效分析

Clinical efficacies of voriconazole and amphotericin B in treatment of acute lymphoblastic leukemia complicated with invasive fungal infections

目的探讨分析伏立康唑与两性霉素B治疗急性淋巴细胞白血病真菌感染的临床疗效及安全性。方法回顾性分析2008年2月-2013年5月收治的急性淋巴细胞白血病合并侵袭性真菌感染的患者94例,将其随机分为伏立康唑组及两性霉素B组,每组各47例,伏立康唑组给予伏立康唑配合一般支持治疗;两性霉素B组给予两性霉素B配合一般支持治疗;比较两组治疗效果及不良反应发生率。结果真菌感染患者治疗后总有效率伏立康唑组为72.34%,两性霉素B组为53.19%;不良反应发生率两性霉素B组为44.68%,伏立康唑组为21.28%,伏立康唑组消化道反应、肝功能损害和肾功能损害发生率明显低于两性霉素B组,差异均有统计学意义(P<0.05)。结论伏立康唑治疗急性淋巴细胞白血病合并侵袭性真菌感染总有效率较高,并且不良反应发生率较低。

OBJECTIVE To explore the clinical efficacies of safety of voriconazole and amphotericin B in treatment of acute lymphoblastic leukemia complicated with fungal infections.METHODS A total of 94acute lymphoblastic leukemia patients complicated with invasive fungal infections,who were treated in the hospital from Feb 2008to May2013,were retrospectively reviewed and randomly divided into the voriconazole group and the amphotericin B group,with 47cases in each;the voriconazole group was treated with voriconazole combined with conventional supportive treatment,while the amphotericin B group was given amphotericin B combined with conventional supportive treatment;the therapeutic effect and incidence of adverse reactions were observed and compared between the two groups.RESULTS After the treatment of fungal infections,the total effective rate of treatment was72.34%in the voriconazole group,53.19%in the amphotericin B group.The incidence of adverse reactions was44.68%in the amphotericin B group,21.28%in the voriconazole group.The incidence of the gastrointestinal reactions,liver function damage,or renal function damage was significantly lower in the voriconazole group than in the amphotericin B group,and the difference was significant（P〈0.05）.CONCLUSIONThe total effective rate of treatment of acute lymphoblastic leukemia complicated with invasive fungal infections with voriconazole is high,with the incidence of adverse reactions low.