伊曲康唑治疗血液病患者侵袭性真菌感染的多中心回顾性分析

目的 观察伊曲康唑在治疗血液病及造血干细胞移植(HSCT)后患者侵袭性真菌感染(IFI)的疗效和安全性.方法 采取开放、多中心回顾性研究的方法 ,选择2007年1-7月确诊、临床诊断和拟诊IFI的血液病或HSCT患者666例,给予静脉伊曲康唑,按前2天200ms/次、12h静脉滴注1次,第3天起200 ms/次,每天静脉滴注1次的方案治疗,并根据病情序贯伊曲康哗口服液或胶囊.根据临床和微生物学疗效标准,综合评价该药物的疗效,并观察其安全性.结果 全部患者抗真菌治疗的退热有效率为70.1%,治疗有效率为69.5%,其中确诊、临床诊断和拟诊IFI患者的有效率分别为73.7%、68.1%、68.2%,其问差异无统计学意义(P=0.380).全部患者中有58例(8.7%)出现与伊曲康唑相关的不良事件,主要表现为轻中度的肝胆系统和胃肠系统功能受损.结论 伊曲康唑是治疗血液病及HSCT患者IFI有效且安全的药物,适用于抗真菌的经验治疗.

A retrospective study of efficacy and safety of itraconazole for treatment of invasive fungal infection in hematologic diseases

Objective To investigate the effieacy and safety of intravenous itraconazole for the treatment of invasive fungal infection(IFI)in patients with hematological disease or undergoing allogeneic hematopoietic stem cell transplantation(HSCT).MethodsSix hundred and sixty-six patients with above mentioned conditions and diagnosed as IFI from January.2007 to July,2007 were enrolled.Intravenous itraconazole was administered at a dose of200 nag every 12 hours for 2 days and followed by 200 mg every 24 hours.Patients were then switched to oral itraconazole according to the clinical situation Responses were determined on the basis of clinical and microbiological criteria.Results The probability of defervescence Was 69.8%and the total response rates among related to itraconazole were the proven.probable and possible IFI patients were 73.7%.68.1%and 68.2%(P=0.380).Adverse effects were found in 58 patients (8.7%).which were mainly mild to medium reversible dysfunction of liver and gastrointestinal tract, Conclusion Itraconazole is an effective and safe antifungal agent for patients with hematological disease or undergoing HSCT and is suitable for empirical antifungal therapy.