米卡芬净治疗小儿白血病粒缺期肺侵袭性真菌感染的临床观察

摘要

目的:分析、评价米卡芬净治疗小儿白血病粒缺期肺侵袭性真菌感染的临床疗效及安全性.方法:选择2007年1月-2010年7月本院儿科血液病房诊治的小儿白血病并发肺侵袭性真菌感染患儿34例,应用米卡芬净进行治疗,剂量为3-5mg/(kg·d),一次静脉输注,7天为1个疗程,治疗1-4疗程,同时动态监测G试验、肺高分辨CT及各脏器功能指标.结果:痊 愈16例,显效6例,进步5例,无效7例,总有效率为 64.7%.死亡8例,病死率为23.5%.本组患儿未发现不良反应.结论:加强早期诊断,尤其动态监测G试验及高分辨肺CT及早进行拟诊肺侵袭性真菌感染是治疗成功的关键,米卡芬净在小儿白血病粒缺期肺侵袭性真菌感染治疗中显示了安全、有效的抗真菌作用.%Objective :To assess the clinical effects , safety and tolerability of micafungin in neutropenic pediatric leukemia with pulmonary mvasive fungal infection. Methods : Thirty - four cases diagnosed with pulmonary invasive fungal infection received 3 - 5mg/kg per day micafungin. Intravenous infusion was given in seven days with dynamic monitoring of G - test, pulmonary CT examination and organs function. Results : Sixteen cases cured and six with obvious effect, five improved and seven without effect. Eight died, mortality was 23. 5％ . There were no apparent side effects. Conclusion : The successful key was early diagnosis , dynamic monitoring of G - test and pulmonary CT examination , prompt treatment of probable diagnosis with invasive fungal infection. Micafungin is both effective and tolerable for use in neutropenic pediatric leukemia with pulmonary invasive fungal infection.