米卡芬净对儿童恶性血液病并发侵袭性真菌感染效果

EFFECT OF MICAFUNGIN ON CHILDREN WITH HEMATOLOGIC MALIGNANCIES COMPLICATED WITH INVASIVE FUNGAL INFECTION

目的观察米卡芬净（MCM）治疗儿童恶性血液病并发侵袭性真菌感染（IFI）的效果。方法2012年1月～2013年7月，本院诊断儿童恶性血液病并发IFI病儿15例，其中肺部感染13例，肺部感染合并血液感染1例，血液感染1例。应用MCM进行治疗，剂量为3～4mg·kg。·d^-1，每天1次，疗程2周～1月。结果确诊1例，治疗无效；临床诊断5例，痊愈l例，显效1例，进步1例，无效2例；拟诊9例，痊愈1例，显效7例，进步1例；总体有效率为66．67％。有2例病儿在用药过程中出现皮疹、腹泻，给予相应处理后症状消失。结论MCM治疗儿童恶性血液病并发IFI效果及用药安全性较好。

Objective To observe the clinical effects and adverse reactions of micafungin in the treatment of children with hematologic malignancies （HM） complicating invasive fungal infection （IFI）. Methods Fifteen children with HM complicating IFI were treated during Jan. 2012-Jul. 2013 in our hospital. Of whom, pulmonary infection in 13 patients, pulmonary infection complicated with bloodstream infection one, and bloodstream infection one. Micafungin was used for therapy, a dose of MCM 3-4 mg/（kg·d） was given, once a day, for 2-4 weeks. Results One patient with confirmed diagnosis failed in treatment. In the five of clinically diagnosed, one was cured, one was much improved, one improved, and failed in two. A suspected diagnosis was made in nine patients, of whom, one was cured, seven were markedl effective, one improved. An overall effective rate was 66.67%. Two sick children developed skin rash or diarrhea during medication, their symptoms disappeared after corresponding management. Conclusion Micafungin is effective and safe in the treatment of children with hematologic malignancies complica ting invasive fungal infection.