伊曲康唑对白血病患者化疗期间真菌感染的治疗效果

Effect of itraconazole on treatment of fungal infections during chemotherapy in patients with leukemia

目的分析伊曲康唑在白血病患者化疗期间真菌感染的预防和治疗效果。方法选择医院2014年3月-2017年1月收治的218例白血病化疗患者作为研究对象,随机分为对照组和观察组,每组109例,对照组采用常规感染预防方案对其进行感染预防,观察组在对照组的基础上加用伊曲康唑注射液,比较两组患者化疗前、完成化疗疗程后的中性粒细胞数、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)变化情况,比较两组患者的真菌感染率及死亡率。结果两组患者化疗完成后,中性粒细胞计数均较化疗前显著降低(P<0.05),hs-CRP、PCT、IL-6均较治疗前升高(P<0.05);且观察组中性粒细胞计数、hs-CRP、PCT及IL-6分别为(40.22±4.56)%、(14.53±2.46)mg/L、(1.28±0.20)mg/L、(7.26±1.22)ng/ml,对照组以上指标分别为(32.61±4.15)%、(63.65±6.47)mg/L、(3.14±0.31)mg/L、(16.79±2.35)ng/ml,差异有统计学意义(P<0.05);观察组真菌感染率为0.92%,显著低于对照组8.26%(P<0.05);对照组死亡率为2.75%显著高于观察组0.92%(P<0.05)。结论白血病患者化疗期间给予包含伊曲康唑的抗菌药物方案预防患者真菌感染可明显降低真菌感染率,伊曲康唑治疗对大部分真菌感染患者有效。

OBJECTIVE To analyze the efficacy of itraconazole in the prevention and treatment of fungal infections in leukemia patients during chemotherapy.METHODS A total of 218 leukemia patients with chemotherapy in our hospital from Mar.2014 to Jan.2017 were selected as the research objects,and were randomly divided into control group and observation group,with 109 cases in each group.Patients in control group used the conventional infection prevention scheme to prevent infections,and in observation group were treated with itraconazole injection on the basis of control group.The changes of number of neutrophils,high sensitivity C reactive protein（hs-CRP）,procalcitonin（PCT）and interleukin-6（IL-6）before and after chemotherapy of the two groups were compared.The fungal infection rate and mortality of the two groups of patients were compared.RESULTS The neutrophil counts of the two groups of patients after chemotherapy were significantly lower than those before chemotherapy（P〈0.05）,and hs-CRP,PCT and IL-6 were all higher than those before treatment（P〈0.05）.The neutrophil count,hs-CRP,PCT and IL-6 of observation group were（40.22±4.56）%,（14.53±2.46）mg/L,（1.28±0.20）mg/L and（7.26±1.22）ng/ml,and those of control group were（32.61±4.15）%,（63.65±6.47）mg/L,（3.14±0.31）mg/L and（16.79±2.35）ng/ml,and the differences were significant（P〈0.05）.The fungal infection rate of observation group was 0.92%,which was significantly lowere than 8.26% of control group（P〈0.05）.The mortality of control group was 2.75%,which was significantly higher than 0.92% of observation group（P〈0.05）.CONCLUSION Using antibiotics prevention scheme containing itraconazole can significantly reduce the rate of fungal infection in patients during chemotherapy of leukemia patients,and itraconazole is effective in treatment of most fungal infections.