摘要
目的观察侵袭性真菌感染(IFI)高危肾移植患者围手术期应用米卡芬净预防及治疗的疗效。方法将28例IFI高危肾移植患者随机分为试验组和对照组,试验组于术后或激素冲击治疗1～3 d即开始应用米卡芬净50 mg/d,疗程10～14 d;对照组不用抗真菌药物,治疗过程中定期进行GM试验、G试验及痰真菌检测,必要时行肺CT检查;对于可疑及确诊的IFI患者将米卡芬净剂量增加至100～150 mg/d,直至病情稳定停药,如果用药3～5 d临床效果不明显宜更换抗真菌药物。结果试验组14例患者均未发生真菌感染,而对照组14例患者中有4例(28.6%)发生可疑或确诊真菌感染,应用米卡芬净治疗分别为3、9、12周,3例患者治愈,1例因效果不理想改用伏立康唑治疗,患者均安全度过围手术期。结论对于高危肾移植患者,围手术期应用米卡芬净预防或治疗IFI疗效显著,无不良反应,值得临床推广应用。
OBJECTIVE To investigate the efficacy of micafungin for the prevention and treatment of invasive fungal infections（IFI） in high-risk patients on kidney transplantation in perioperative period.METHODS Totally 28 cases with high risk factors of renal transplantation were randomly divided into test group and contrast group.The high risk factors included diabetic renal failure or poor control of glucose level,fungal infection history,perioperative polyclonal antibody induction therapy,hormone impact or antibody treatment for acute rejection,etc.In test group,micafungin was used 50mg per day after operation or hormone impact for 1 to 3 days.The treatment course was 10 to 14 days.While the control group without antifungal agents.Serum aspergillus galactomannan（GM）,G test and sputum fungi detection was performed during therapy.Pulmonary CT scan was used if necessary.When the patients were suspected or diagnosed as IFI,the dosage of micafungin was increased to 100-150mg per day.RESULTS With no occurrence of fungal infections in test group,while in the control group,the occurrence of IFI were in 4 patients（28.6%）,Micafungi was used for 3 to 12 weeks,among them 3 cases were cured,while 1 case was changed voriconazole for poor effect.CONCLUSION Micafungin is effective and safe in the prevention and treatment of IFI for the high risk patients with kidney transplantation,and it is worth the promotion and application in clinics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第2期339-340,共2页
Chinese Journal of Nosocomiology
关键词
米卡芬净
侵袭性真菌感染
肾移植
Micafungin
Invasive fungal infections
Kidney transplantation
