伏立康唑治疗儿童白血病侵袭性肺部真菌感染疗效观察

Efficacy of voriconazole in the treatment of invasive pulmonary fungal infection in children with leukernia

目的观察伏立康唑治疗儿童白血病侵袭性肺部真菌感染的疗效和安全性。方法选取2010年1月至2016年1月湖南省儿童医院血液内科收治的白血病侵袭性肺部真菌感染患儿43例为研究对象,随机分为观察组22例和对照组21例。对照组行两性霉素B治疗,观察组行伏立康唑治疗,比较两组临床疗效、细菌清除率及用药期间的不良反应(肝脏损害、低钾血症、肾脏损害、静脉炎及消化道反应)。结果观察组治疗总有效率及细菌清除率分别为81.8%(18/22)、86.4%(19/22),均显著高于对照组52.4%(11/21)、57.1%(12/21),差异有统计学意义(P<0.05)。观察组不良反应发生率为13.6%(3/22),显著低于对照组42.9%(9/21),差异有统计学意义(P<0.05)。结论儿童白血病侵袭性肺部真菌感染采用伏立康唑进行治疗,具有获得良好的临床效果。

ObjectiveTo observe the efficacy and safety of voriconazole in the treatment of invasive pulmonary fungal infection in children with leukemia.MethodsForty three children with invasive pulmonary fungal infection were randomly divided into observation group(n=22)and control group(n=21).The control group was treated with amphotericin B and the observation group was treated with voriconazole.The clinical efficacy,bacterial clearance and adverse reactions(liver damage,hypokalemia,renal damage,phlebitis and gastrointestinal reactions)were compared between the two groups.ResultsThe total effective rate and bacterial clearance rate of the observation group were81.8%(18/22)and86.4%(19/22)respectively,which were significantly higher than those of the control group[52.4%(11/22),57.1%(12/21)],the difference being statistically significant(P<0.05).The incidence of adverse reactions in the observation group was13.6%(3/22),which was significantly lower than that in the control group(42.9%,9/21),the difference being statistically significant(P<0.05).ConclusionVoriconazole,as a drug for invasive pulmonary fungal infection in children,is safe and effective and deserves to be widely used clinically.