伊曲康唑注射液治疗血液系统恶性肿瘤伴发真菌感染51例临床分析

目的观察伊曲康唑注射液治疗血液系统恶性肿瘤患者伴发真菌感染的临床疗效及安全性。方法选择浙江大学医学院附属第一医院血液科2004年2月至2005年4月住院恶性血液病患者51例。男35例、女16例,中位年龄42岁。确诊或拟诊真菌感染或经验性治疗使用伊曲康唑,剂量为:每次200mg,每12h1次;用2d后,每次200mg,每天1次,完成疗程7d以上评价疗效。完成者共49例,疗程为7～32d,中位数14d。结果伊曲康唑注射液临床总有效率59.2%,真菌清除率为71.4%。副反应中没有发现用药时寒战、发热等,以及胃肠道反应。肝功能异常发生率7.8%,肾功能损害发生率2%。结论伊曲康唑注射液抗菌谱较广,其注射液在治疗深部真菌感染中为高效药物,且药物安全性良好,但在使用时尚需监测肝功能。

Intraconazol injection for treatment of fungal infections in 51 patients with malignant hematologic diseases

Objective To observe the therapeutic effect and side effects of itraconazol infection for fungal infections in patients with malignant hematologic deseases.Methods 51 patients(male 35,female 16; average age 42 years)with malignant hematologic diseases who confirmed or suspected fungal infection and for empiric treatment were given itraconazole infection in a dose of 200 mg twice daily in the first and the second days,from the third day in a dose of 200 mg once daily.49 patients were given itraconazol injection for 7~32 days(average time 14days).Results The clinical efficacy rate of itraconazol injection was 59.2%,and the fungal elimination rate was 71.4%.Among the side effects,there were no rigor and fever,but hepatotoxiciy were present in 7.8%and nephrotoxicity in 2%.Conclusion As itraconazole has a broad anti-fungal spectrum and relatively good efficacy,itraconazole infection is a high-efficiency drug with low side efficiency in treatment of systematical fungal infections.But the hepatic and renal function tests must be carried out regularly when itraconazole infection is used.