摘要
目的:评价恶性血液病伴侵袭性真菌感染(IFI)患者应用伏立康唑、卡泊芬净和米卡芬净的疗效,并探讨影响抗真菌疗效的相关因素。方法:回顾性分析天津市第一中心医院94例恶性血液病伴IFI患者的临床资料,采用卡方检验及Logistic回归分析,研究影响抗真菌药物治疗IFI疗效的相关因素。结果:患者应用抗真菌药物的总有效率为64. 89%,伏立康唑、卡泊芬净和米卡芬净的有效率分别为66. 67%,60. 00%和65. 00%,3种抗真菌药物在该类患者中的疗效无统计学差异。Logistic回归分析显示,粒细胞缺乏持续天数和用药天数是影响抗真菌药物疗效的主要因素。结论:伏立康唑、卡泊芬净和米卡芬净对恶性血液病伴IFI患者均有较好疗效。在临床使用中,中性粒细胞缺乏天数越短,用药时间越长,抗真菌药物的疗效越佳。
Objective:To evaluate the anti-fungal efficacies of voriconazole,caspofungin and micafungin in patients of hematological malignancies with invasive fungal infection (IFI),and explore the influencing factors. Methods:A retrospective analysis of 94hematologic patients complicated with IFI from January 2015to April 2016 in Tianjin First Central Hospital was conducted.The clinical data was analyzed by chi-square test and logistic regression analysis to determine the main influencing factors for the anti-infection efficacy.Results:The overall response rate to the three antifungal agents was 64.89%.The overall effective rates of voriconazole,caspofungin and micafungin were 66.67%,60.00%and 65.00%,respectively.The differences were not statistically significant among the three groups.The lasting time of agranulocytosis and length of therapy were the main influencing factors of the anti-infection efficacy.Conclusion:In this study,voriconazole,caspofungin and micafungin all had good efficacy in treatment of IFI in patients with hematological malignancies.The lasting days of agranulocytosis and lasting days of therapy should be paid attention to in clinical practice.The shorter the lasting days of agranulocytosis and the longer the lasting days of therapy are,the better the efficacy of antifungal agents will be.
作者
李梦雪
许高奇
朱立勤
赵明峰
LI Meng-xue;XU Gao-qi;ZHU Li-qin;ZHAO Ming-feng(The First Central Clinical College of Tianjin Medical University,Tianjin 300192,China;Department of Pharmacy,Zhejiang Cancer Hospital,Hangzhou 310022,China;Department of Pharmacy,Tianjin First Central Hospital,Tianjin 300192,China;Department of Hematology Tianjin First Central Hospital,Tianjin 300192,China)
出处
《中国新药杂志》
CAS
CSCD
北大核心
2018年第22期2700-2704,共5页
Chinese Journal of New Drugs
关键词
抗真菌药
侵袭性真菌感染
疗效
影响因素
antifungal agents
invasive fungal infection
therapeutic effect
influential factors
