天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (6): 650-653.doi: 10.11958/20182128

• 临床研究 • 上一篇    下一篇

米卡芬净与氟康唑预防造血干细胞移植真菌感染的临床对比观察

薛慧1 ， 冯术青1 ， 李雪敏2 ， 胡永超1 ， 高峰1△   

  1. 1唐山， 华北理工大学附属医院 （063000）； 2齐鲁工业大学校医院
  • 收稿日期:2018-12-27 修回日期:2019-03-22 出版日期:2019-06-15 发布日期:2019-06-15
  • 通讯作者: 高峰 E-mail:tgxueye@163.com

Clinical comparative observation of micafungin and fluconazole in preventing fungal infection after hematopoietic stem cell transplantation

XUE Hui 1 , FENG Shu-qing1 , LI Xue-min2 , HU Yong-chao 1 , GAO Feng1△   

  1. 1 North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China; 2 Campus Hospital, Qilu University of Technology
  • Received:2018-12-27 Revised:2019-03-22 Published:2019-06-15 Online:2019-06-15

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摘要： 摘要： 目的 对比米卡芬净与氟康唑预防异基因造血干细胞移植 （Allo-HSCT） 患者早期侵袭性真菌病 （IFD） 的疗效。方法 回顾性分析外周血Allo-HSCT的82例患者， 观察组 （42例） 在预处理后粒细胞缺乏期间开始给予米卡芬净静脉滴注至白细胞稳定植入停用， 余时间给予氟康唑口服； 对照组 （40例） 全程给予氟康唑口服。随访至移植后 100 d， 对比2组IFD发生率、 药物不良反应发生率。结果 观察组和对照组IFD发生率分别为7.1% （3例） 和22.5% （9 例）， 差异有统计学意义 （χ2 =3.868， P＜0.05）； 2组真菌预防药物不良反应发生率分别为11.9% （5例） 和15.0% （6例），差异无统计学意义 （χ2 =0.169， P＞0.05）； 2组应用ATG患者与未应用ATG患者IFD的发生率差异无统计学意义 （P＞ 0.05）。结论 Allo-HSCT真菌感染预防方案中， 米卡芬净联合氟康唑可有效降低移植患者早期IFD的发生率， 且未增加药物不良反应。

关键词: 抗真菌药, 氟康唑, 造血干细胞移植, 真菌病, 米卡芬净

Abstract: Abstract: Objective To compare the effects of micafungin and fluconazole in preventing early invasive fungal disease (FID) in patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Methods Data of 82 Allo-HSCT patients were retrospectively analyzed. The observation group (n=42) was given intravenous micafungin until the leukocytes were stable after implantation, and the rest time was given fluconazole. The control group (n=40) was given the oral fluconazole. The patients were followed up to 100 days after transplantation. The incidence of IFD and adverse drug reactions were compared between the two groups. Results The incidence of IFD was 7.1% (3 cases) in the observation group and 22.5% (9 cases) in the control group, the difference was statistically significant (χ2 =3.868, P＜0.05). Drug-related adverse reactions were 11.9% (5 cases) vs. 15.0% (6 cases) in the two groups, and there was no significant difference between two groups (χ2patients and those without ATG (P＞0.05). Conclusion Micafungin combined with fluconazole can effectively reduce the incidence of IFD in the early stage of Allo-HSCT patients, and without incensement of adverse drug reactions. =0.169, P＞0.05). There was no significant difference in the incidence of IFD between the two groups of ATG

Key words: antifungal agents, fluconazole, hematopoietic stem cell transplantation, mycoses, micafungin