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目的分析伏立康唑治疗恶性血液病患者合并侵袭性真菌感染(IFI)临床疗效和安全性。方法 88例患者予以伏立康唑抗真菌治疗,从临床表现、影像学和病原学3个方面评价疗效,并观察药物不良反应。结果 IFI发生率24.0%,其中肺部感染最多见,占68.2%;所有IFI患者发热占87.5%,60例肺部真菌感染者均出现肺部影像学改变,其中典型改变占54.5%;26例检出假丝酵母菌生长,12例检出曲霉菌属,有58例经治疗有效,总有效率为65.9%,无效12例,死亡18例,死亡率20.5%;主要不良事件是神经精神症状、视觉异常和皮疹;88例可评价病例中无因不能耐受药物相关不良事件而退出治疗。结论伏立康唑是治疗恶性血液病患者IFI的高效及安全的药物,同时其所引发的不良事件较少。
Objective To analyze the clinical efficacy and safety of voriconazole in the treatment of patients with hematologic malignancies complicated with invasive fungal infection (IFI). Methods Eighty - eight patients were treated with voriconazole for antifungal therapy. The clinical efficacy, imaging and etiology were evaluated in three aspects. Adverse reactions were observed. Results The incidence of IFI was 24.0%, of which the most common was pulmonary infection, accounting for 68.2%. The incidence of fever in all IFI patients was 87.5%. The lung imaging changes were found in 60 cases of pulmonary fungal infection, with typical changes accounting for 54.5% Candida growth was detected in 12 cases. Aspergillus was detected in 12 cases, of which 58 cases were treated effectively. The total effective rate was 65.9%, 12 cases were ineffective, 18 cases died and the mortality rate was 20.5%. The main adverse events were neuropsychiatric symptoms , Visual abnormalities and rashes; 88 patients can not be evaluated due to unbearable drug-related adverse events and exit treatment. Conclusion Voriconazole is an effective and safe drug for the treatment of IFI in patients with hematologic malignancies, and its incidence of adverse events is low.