摘要
目的探讨国产伏立康唑在血液病患者合并侵袭性真菌病(IFD)治疗中的临床疗效、不良反应及相关影响因素。方法收集该院血液科2012年1月至2017年1月住院期间采用国产伏立康唑治疗的IFD患者154例,分析患者的临床特征、影像学特征、病原学特征、分层诊疗时机,临床疗效、不良反应及其影响因素。结果伏立康唑治疗血液病患者合并IFD的总有效率为70.8%,各IFD诊断分层间有效率比较,差异无统计学意义(P=0.077);单因素分析结果显示抗真菌治疗后退热时间(P=0.001)、G试验结果(P=0.017)影响患者的治疗效果;不良反应以电解质紊乱为主(99例,64.3%),但改善迅速且不影响总疗程。结论国产伏立康唑对血液病患者合并IFD治疗效果较好,其不良事件较少且多能耐受。
Objective To evaluate the efficacy,safety,and influencing factors of voriconazole for invasive fungal disease(IFD)in patients with hematologic diseases.Methods Patients with hematologic diseases complicated with IFD in our hospital from Jan 2012 to Jan 2017 were involved in this study.The clinical features,imaging and pathogen distribution,diagnosis and treatment time were analyzed,then the efficacy,adverse reaction,and influencing factors of voriconazole were evaluated.Results The overall effective rate of voriconazole was 70.8%.There was no significant difference in the efficiency among the hematologic diseases complicated with IFD(P=0.077).Univariate analysis showed that antipyretic time after antifungal therapy(P=0.001)and G test results(P=0.017)were significantly associated with favorable outcome.Electrolyte imbalance was the main drug-related adverse reaction(99 cases,64.3%),but it did not affect the efficacy of voriconzole.Conclusion Voriconzole is an effective and well-tolerated antifungal agent for IFD in patients with hematologic diseases.
引文
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