曼袭性真菌感染的血液病患者采用卡泊芬净经验性抗真菌治疗的效果

目的探讨卡泊芬净在血液病患者经验性抗真菌治疗中的疗效。方法选取我院2008年10月～2010年10月收治的抗生素治疗无效且怀疑真菌感染的血液病患者40例，随机分为两组，A组20例患者给予卡泊芬净治疗，第1天70mg静脉滴注，第2天起50mg静脉滴注；B组20例患者给予脂质体两性霉素B治疗，3mg/（kg·d）静脉滴注，两组均治疗10d，观察两组患者的疗效和不良反应。结果两组总有效率比较（66．7％US61．1％），差异无统计学意义（X^2=1．17，P〉0．05），但A组肾毒性、输液反应发生率明显低于B组（X^2=4．37、4．37，均P〈0．05）。结论卡泊芬净用于经验性抗真菌治疗，效果较好，患者耐受性较好，是侵袭性真菌感染的一个较好选择。

Efficacy observation of Caspofungin in empirical antifungal treatment of invasive fungal infection patients with hemopathy

Objective To evaluate efficacy of Caspofungin in empirical antifungal treatment of invasive fungal infection patients with hemopathy.Methods 40 cases of hematopathy patients with persistent fever,invalid antibiotic treatment,invasive fungal infection in our hospital from October 2008 to October 2010 were randomly divided into two groups,20 patients in group A were given Caspofungin therapy,the first day of 70 mg intravenous infusion,and 50 mg from the next day;20 patients in group B were treated with liposomal Amphotericin B,3 mg/(kg·d) intravenous infusion,both groups were treated for 10 days,the efficacy and adverse reactions of two groups were observed.Results There was no significant difference in total effective rate of two groups(66.7% vs 61.1%)(χ2 = 1.17,P > 0.05),but the incidence of kidney toxicity,infusion reaction of group A were significantly lower than group B(χ2 = 4.37,4.37,all P < 0.05).Conclusion The efficacy of Caspofungin in empirical antifungal treatment of invasive fungal infection patients with hemopathy is good,with tolerance better patient,and it is a better choice for invasive fungal infection.