抗真菌新药卡泊芬净在血液病患者经验性抗真菌治疗中的疗效观察

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 将2008年10月至2010年10月收治的40例抗生素治疗无效且怀疑真菌感染的血液病患者随机分为两组,各20例,A组给予卡泊芬净治疗,第1天70 mg静脉滴注,第2天起50 mg静脉滴注;B组患者给予脂质体两性霉素B治疗,3 mg/(kg·d)静脉滴注.两组均治疗10 d,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% vs.61.1%),差异无统计学意义(χ2=1.17,P>0.05),但A组肾毒性、输液反应发生率明显低于B组(χ2=4.37,4.37,P<0.05).结论 卡泊芬净用于血液病患者经验性抗真菌治疗,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.

Study on efficacy of caspofungin in empirical antifungal treatment of neutropenic patients

Objective To evaluate the efficacy of caspofungin in empirical antifungal treatment of neutropenic patients with persistent fever.Methods Forty cases of hematonostic patients and invalid antibiotic treatment,suspected fungal infection in this hospital during October 2008 to October 2010 were randomly divided into two groups,20 patients in group A were given with caspofungin therapy,70mg intravenous infusion at first day,and 50 mg at next day;20 patients in group B were treated with liposomal amphotericin B,3 mg/（kg o d） intravenous infusion,the therapeutic course in both groups was 10 days,and the efficacy and adverse reactions of these two groups were observed and compared.Results There was no significant difference in total effective rate between these two groups（66.7% vs 61.1%）（χ2 = 1.17,P0.05）,but the incidence of renal toxicity and infusion reaction in group A was significantly lower than that of group B（χ2=4.37,4.37,P0.05）.Conclusion The efficacy of caspofungin in empirical antifungal treatment of neutropenic patients with persistent fever is good,its tolerance in patients is good,and it is a better choice for treatment of invasive fungal infection.