伊曲康唑注射液治疗恶性血液病患者合并真菌感染的疗效观察

目的研究伊曲康唑注射液治疗恶性血液病患者不同分层诊断真菌感染的疗效。方法收集2003年1月—2006年12月按照欧洲癌症研究和治疗组织(EORTC)分层诊断标准诊断的真菌感染患者50例,其中确定诊断13例,临床诊断24例,拟诊13例。全部病例均于诊断后给予伊曲康唑注射液治疗,200mg/次,第1、2天每天2次,以后每天1次。并依病情调整,疗程1～3个月。结果总有效率为62.0%(31/50);确诊病例、临床诊断病例和拟诊病例的有效率分别为69.2%(9/13)、83.3%(20/24)和15.4%(2/13);具有影像学主要特征、次要特征患者的有效率分别为90.5%(19/21)和69.2%(9/13)。临床诊断病例和拟诊病例的疗效差异有统计学意义(P<0.01),其余各组间比较,差异无统计学意义(P>0.05)。结论伊曲康唑注射液是治疗恶性血液病患者合并真菌感染的有效药物,而且具有肺部影像学表现的患者比单纯不明原因发热的患者疗效好。

The therapeutic effect of itraconazole on malignant hematological diseases complicated with fungal infections

Objective To study the efficacy of intravenous administration itraconazole on fungal infections associated with malignant hematological diseases according to stratified diagnoses. Methods Fifty patients with malignant hematological diseases, which were diagnosed from Jan 2003 to Dec 2006, accoding to the criteria of European Organization for Research and Treatment of Cancer （EORTE）, were complicated fungal infections. Including 13 cases of them were confirmed diagnosis,24 casesof them were clinical diagnosis,and 13 eases of them were suspected.All eases were underwent intravenous injection of itraconazole 200 nag bid for 2 days, and then once a day injection followed by patients condition. The course of treatment lasted 1 - 3 months.Results The totally effective rate was 62.0%（31/50）, which there was 69.2%（9/13）, 83.3% （20/24） and 15.4%（2/13） in confirmed diagnosis group, clinical diagnosis group,and suspected diagnosis group respectively. The effective rotes of the patients with major imaging signs and those with secondary imaging signs were 90.5 % （19/21） and 69.2%（9/14） respectively. There was a significant difference between the therapeutic effects in the patients with confirmed diagnosis and those with suspected diagnosis （ P 〈0.01）, and no statistical significant was found in other intragroups comparison （ P 〉 0.05）. Conclusion The intravenous administration of itraconazole had been proved to be effective to treat fungal infections asseciated with malignant hematological diseases. Furthermore,it had better results in confirmed diagnosis patients, which positive imaging findings in lung images, than patients which simply fever of undetermined origin.