伊曲康唑与氟康唑预防成人急性白血病侵袭性真菌感染的疗效比较

目的 探索对成人急性白血病患者临床预防侵袭性真菌感染的有效方法.方法 采用非随机同期对照实验的方法,将符合实验标准的84例急性白血病患者分为实验组和对照组,每组42例.实验组给予伊曲康唑200 mg·次-1,口服,1次·d-1,共15 d;对照组给予氟康唑150 mg·次-1,口服,1次·d-1,共15 d.结果 两组用药前后丙氨酸氨基转移酶(ALT)、总胆红素和血肌酐比较,均P＞0.05,差异无统计学意义.两组间真菌感染(确诊+临床诊断+拟诊)率分别为19.0%和40.5%;真菌感染(确诊+临床诊断)率分别为14.3%和33.3%,经χ2检验均P＜0.05,可认为两组间真菌感染率具有显著性差异.两组间心电图异常发生率分别为9.5%和4.8%,但差异无统计学意义(P＞0.05).结论 伊曲康唑预防急性白血病患者真菌感染的发生较氟康唑更具有优越性,且安全可靠.

Impact of itraconazole versus fluconazole in preventing invasive fungal infection in patients with adult acute leukemia

Objective: To evaluate an effective way to clinically prevent of invasive fungal infection.Methods: In a non-randomized concurrent control trial,84 cases of acute leukemia patients who met the test standard were divided into experimental and control group.To prevent fungal infections,the experimental group was given itraconazole at a dose of 200 mg once a day for 15 days;control group was given fluconazole at a dose of 150 mg once a day for 15 days.Results: Before and after prevention,the ALT,total bilirubin and serum creatinine of experimental and control group,there was a significant difference between the two groups(P<0.05).The rate of fungal infection(confirmed,clinical and suspected diagnosis) in experimental group was 19.0%,and 40.5% in control group,respectively.The rate of fungal infection(confirmed and clinical diagnosis) in experimental group was 14.3%,and 33.3% in control group,respectively.There was a significant difference between the two groups(P<0.05).The incidence of ECG abnormalities in experimental group was 9.5%,and 4.8% in control group,respectively.There was not a significant difference between the two groups(P>0.05).Conclusions: Itraconazole to prevent fungal infection was more superior than fluconazole and was safe and reliable.