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目的分析血液系统疾病合并真菌感染的临床特点、易感因素及探讨防治策略。方法对2001年1月至2006年12月上海交通大学医学院附属新华医院收治的97例血液病患者合并肺部真菌感染情况进行回顾性分析。结果97例患者真菌培养获得真菌201株,其中念珠菌147株,占73.1%;17.5%为两种真菌感染,71.8%伴细菌感染;相关病死率为23.7%。二性霉素B脂质体与伊曲康唑对血液病合并肺部真菌感染患者有效率分别为66.7%和63.6%。结论真菌感染是血液系统疾病继发感染的主要病原体之一,早期诊断与治疗是病情缓解与长期生存的关键。二性霉素B脂质体与伊曲康唑是治疗真菌感染的常用的有效药物。
Objective To analyze the clinical features, susceptibility factors and prevention and cure strategies of hematologic diseases with fungal infection. Methods A retrospective analysis was performed on 97 cases of hematological diseases with pulmonary fungal infection admitted to Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from January 2001 to December 2006. Results Fungal cultures of 97 patients were obtained with 201 strains of fungi, of which 147 strains were Candida albicans (73.1%), 17.5% were two fungal infections and 71.8% were associated with bacterial infection, and the related case fatality rate was 23.7%. The effective rates of amphotericin B liposomes and itraconazole in patients with blood diseases and pulmonary fungal infections were 66.7% and 63.6%, respectively. Conclusion Fungal infection is one of the major pathogens of secondary infection of hematological diseases. Early diagnosis and treatment are the key to remission and long-term survival. Amphotericin B liposomes and itraconazole are commonly used and effective drugs for the treatment of fungal infections.