卡泊芬净治疗癌症患者侵袭性真菌感染疗效分析

目的观察卡泊芬净治疗癌症患者合并侵袭性真菌感染（IFI）的疗效和安全性。方法选择经氟康唑治疗无效和不能耐受两性霉素B的54例侵袭性真菌感染的癌症患者,其中氟康唑治疗无效的30例为A组,不能耐受两性霉素B治疗的24例为B组,两组都给予卡泊芬净治疗,治疗时间均持续至体温正常后5d或连续痰涂片阴性后3d,或者疗程达14d,观察并评价卡泊芬净的疗效和毒副作用。结果卡泊芬净治疗癌症患者合并侵袭性真菌感染患者的总有效率为72.2%,其中A组30例,有效率66.7%;B组24例,有效率79.2%。毒副作用少,发生不良反应者占20.4%,包括电解质紊乱、静脉炎、胃肠道反应、转氨酶异常等,但以上反应均不严重,经对症处理后缓解。结论卡泊芬净治疗癌症患者合并侵袭性真菌感染有效,且安全,可在临床推广应用。

Efficacy analysis of caspofungin treatment of invasive fungal infections in cancer patients

Objective To investigate efficacy and safety of caspofungin treatment in cancer patients with invasive fungal Infections(IFI).Methods The patients were divided into Group A and Group B.The 30 patients failed in Fluconazole therapy formed Group A,while the 24 patients who couldn’t tolerate Amphotericin formed Group B.Patients from both Group A and B had no significant difference in age,gender or pathology(P>0.05).Thus Group A and Group B were comparable.All these patients received caspofungin treatment and the treatment time continued until 5d after the body temperature becoming normal or 3d after aputum smear consecutive becoming negative or treatment of 14d.The efficacy and toxicity of Caspofungin have been evaluated.Results The total effective rate of caspofungin treatment of invasive fungal infections in cancer patients was 72.2%.Among them,the effective rate of the 30 patients in Group A was 66.7% and 79.2% of the 24 patients in Group B.The caspofungin treatment has had fewer toxicity effects.And the toxicity effects include electrolyte imbalance,phlebitis,gastrointestinal tract,abnormal transaminase,etc.The rate of the 54 patients receiving this treatment who have suffered the toxicity effects was 20.4% and the toxicity effects were not serious which could be eased by relevant symptomatic treatment.Conclusion Caspofungin treatment in Cancer patients with Invasive fungal Infections is effective and safe.