摘要
目的分析急性髓系白血病患者化疗后确诊为侵入性真菌感染(IFI)病例,探讨卡泊芬净联合两性霉素B治疗的疗效与安全性。方法 2011年10月收治1例急性髓系白血病M2型患者,其在化疗间歇期合并严重肺部感染及出血,胸部CT见双肺感染、右肺大片实变影,采用比阿培南、万古霉素抗细菌感染效果欠佳,最终经过支气管镜检查病理确诊为侵入性真菌感染,抗真菌治疗对伏立康唑敏感性欠佳,之后应用卡泊芬净联合两性霉素B抗真菌治疗,监测其不良反应及疗效。结果确诊IFI感染的患者给予卡泊芬净联合两性霉素B抗真菌治疗约2个月,症状、体征及胸部CT影像学的监测,疾病得到及时有效控制,肺部感染治愈,临床表现完全消失,病情稳定,且无不良反应发生。结论急性髓系白血病巩固化疗中可出现侵入性真菌感染,病理确诊为金标准,卡泊芬净联合两性霉素B治疗恶性血液病患者合并IFI疗效确切、安全性好。
OBJECTIVE To analyze one case of acute myeloid leukemia patient who was diagnosed as invasive fungal infections after the chemotherapy and explore the efficacy and safety of caspofungin combined with amphotericin B for treatment of the confirmed cases.METHODS Intermittent chemotherapy for acute myeloid leukemia M2 in patients with severe pulmonary infection and bleeding,chest CT showing bilateral pulmonary infection and the blockbuster right lung opacities.United biapenem vancomycin resistance to bacterial infection was ineffective,and the invasive fungal infections were finally confirmed after the bronchoscopy for pathology,then the antifungal therapy was performed by using caspofungin combined with amphotericin B,while the adverse reactions and the clinical efficacy were monitored.RESULTS After the antifungal therapy with caspofungin combined with amphotericin B for nearly tow months,all the confirmed cases with IFI were effectively controlled through the monitoring of symptoms and the retest of signs and chest CT imaging,with the pulmonary infections healed,the symptoms gone completely,the condition of leukemia stable,and the adverse reactions did not occur.CONCLUSIONThe invasive fungal infections may occur during the consolidated chemotherapy of acute myeloid leukemia,and the pathological diagnosis can be served as the gold standard;caspofungin combined with amphotericin B can achieve accurate and safe clinical efficacy in treatment of the hematologic malignancies patients complicated with IFI.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第14期3369-3371,共3页
Chinese Journal of Nosocomiology
基金
国家自然科学基金(31200686)
