恶性血液病合并肺部侵袭性真菌感染31例临床分析

目的探讨恶性血液病合并肺部侵袭性真菌感染（invasive fungal infection,IFI）的临床特点。方法对31例并发肺部IFI的恶性血液病患者的临床特征进行回顾性分析。结果广谱抗生素使用时间≥7d,IFI出现前中性粒细胞缺乏时间≥7d,中性粒细胞缺乏持续时间≥10d是并发IFI的重要诱因。感染菌种主要为白色念珠菌（占9.7%,3株）、非白色念珠菌（占12.9%,4株）和曲霉菌（29.1%,9株）。虽经抗真菌治疗,仍有8例患者死于呼吸衰竭。结论恶性血液病患者易于发生IFI,且一旦发生病死率明显增加,应及早进行预防和早期经验性抗真菌治疗。

Clinical study of pulmonary invasive fungal infections in hematological malignancies

Objective To study the clinical characteristics of patients with hematological malignancy accompanying pulmonary invasive fungal infection （IFI）. Methods Thirty-one patients with patients pulmonary IFI were enrolled in this study. The clinical manifestations, fungal spectrum, and treatment outcome of these patients were observed. Results Broad-spectrum antibiotics were used for ≥ 7 days. Neutropenia occurred ≥7 days before development of IFI and its persistentime was ≥10 days, which was the high risk factor for IFI in hematological malignancy. The most common fungal sub types were Candida albicans, non-Candida albicans, and aspergillus. Although amphotericin B and itraconozole, etc, were used in treatment of IFI, 8 patients died of respiratory failure. Conclusion IFI is easy to occur in patients with hematological malignancy. Early prevention and treatment with anti-fungal agents can reduce the mortality of IFI and achieve a better prognosis.