伊曲康唑预防急性白血病患儿侵袭性真菌感染的临床研究

摘要

目的：评价伊曲康唑口服液在急性白血病（AL）患儿化疗后粒细胞缺乏伴感染时侵袭性真菌感染（IFI）预防性治疗的效果。方法回顾性分析2009年6月-2013年6月我院收集的AL化疗后伴粒细胞缺乏的213例患儿，将其分为伊曲康唑早期预防组和晚期预防组。伊曲康唑早期预防组（330例次）在粒细胞缺乏伴发热应用广谱抗生素同时服用伊曲康唑口服液；对照组（191例次）在粒细胞缺乏出现发热、经广谱抗生素应用72 h 后发热无改善者加用伊曲康唑口服液，比较两组患儿IFI发生率。结果伊曲康唑早期预防组和对照组各有7例和18例发生IFI，发生率分别为2.12％和9.42％，两组IFI发生率差异有显著性（P＜0．01）。结论 AL化疗后粒细胞缺乏患儿在发热早期进行预防性口服伊曲康唑可以有效降低IFI的发生率。%Objective To evaluate the efficacy of itraeonazole oral solution for prevention of invasive fungal infection (IFl )in childhood acute leukemia with agranulocytosis patients after chemotherapy. Methods Clinical data of 213 acute leukemia with agranulocytosis patients after chemotherapy from June 2009 to June 2013 were retrospectively analyzed.Patients were divided into itraeonazole early prophylactic treatment group (n =330 )and control group (n =191 ).Patients in the itraconazole group received intraconazole and broad-spectrum antibiotics simultaneously when patients with agranulocytosis suffered from fever.Patients in the control group received intraconazole when their temperature showed no improvement after using broad-spectrum antibiotics for seventy-two hours.Cases suffering from IFI were compared between two groups.Results There were 7 cases(2.12%)suffering from IFI in the itraconazole group and 19 case(9.42%)in the control group.Moreover,there was significant difference between the two groups (P<0.01).Conclusions Itraconazole oral solution can effectively prevent IFI in childhood acute leukemia with agranulocytosis patients after chemotherapy.