泊沙康唑预防血液系统恶性肿瘤患者侵袭性真菌病的疗效和安全性分析

Analysis of the Efficacy and Safety of Posaconazole in Preventing Invasive Fungal Disease in Patients with Hematological Malignancies

目的:评价泊沙康唑预防血液系统恶性肿瘤患者侵袭性真菌病(IFD)的疗效和安全性,寻求安全有效的真菌预防药物。方法:回顾性分析2019年1月~2020年12月期间本院收治的73例血液系统恶性肿瘤患者预防IFD的用药情况及疗效,依据用药情况分为泊沙康唑组(n=44)与伏立康唑组(n=29)。泊沙康唑组给予泊沙康唑口服混悬液,伏立康唑组给予伏立康唑片。比较两组IFD发生率、肝肾功能指标水平以及不良反应发生率。结果:预防用药期间,泊沙康唑组IFD发生率与伏立康唑组比较无统计学差异(P=0.097);伏立康唑组不良反应发生率高于泊沙康唑组(P=0.030);伏立康唑组直接胆红素(DBIL)峰值高于泊沙康唑组(P=0.048)。结论:泊沙康唑和伏立康唑均能有效预防血液系统恶性肿瘤患者发生IFD,但泊沙康唑的不良反应发生率更低、对患者肝功能指标影响更小。

Objective:To evaluate the efficacy and safety of posaconazole in preventing invasive fungal disease(IFD)in patients with hematological malignancies,and to seek safe and effective fungal preventive drugs.Methods:A retrospective analysis was performed on the medication and efficacy of IFD prevention in 73 patients with hematological malignancy admitted to our hospital from January 2019 to December 2020.According to the medication,they were divided into the posaconazole group(n=44)and the voriconazole group(n=29).The posaconazole group was given posaconazole oral suspension,and the voriconazole group was given voriconazole tablets.The incidence of IFD,the levels of liver and kidney function index and incidence rate of adverse drug reactions were compared between the two groups.Results:During the preventive medication period,there was no statistical difference in IFD incidence between the posaconazole group and the voriconazole group(P=0.097).The incidence of adverse reactions in the voriconazole group was significantly higher than that in the posaconazole group(P=0.030),and the peak value of direct bilirubin(DBIL)in the voriconazole group was significantly higher than that in the posaconazole group(P=0.048).Conclusion:Both posaconazole and voriconazole can effectively prevent the occurrence of IFD in patients with hematological malignancies,but the incidence of adverse reactions of posaconazole is lower than that of voriconazole,and the effect on liver function is smaller.