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华西医学  2011 

米卡芬净在造血干细胞移植二级预防中的临床应用分析

, PP. 1783-1786

Keywords: R733.7,R730.5

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Abstract:

【】 目的 探讨米卡芬净在有侵袭性真菌感染(invasivefungalinfection,IFI)病史的患者行造血干细胞移植(haematopoieticstemcelltransplantation,HSCT)时二级预防(secondaryanti-fungalprophylaxis,SAP)的有效性和安全性。 方法 选择2009年1月-2011年1月行HSCT治疗血液病患者中有IFI史的18例患者,从预处理进行SAP,13例开始即使用米卡芬净钠,5例开始选用伏立康唑,后换为米卡芬净。预防至危险期结束(白细胞植活、无感染症状),18例患者随访时间62~220d,中位随访时间为124d。 结果 米卡芬净治疗有效17例,1例在预防期间+27d出现真菌突破感染。预防过程中1例在输注的第2天出现躯干充血性皮疹伴瘙痒,经抗过敏治疗后逐渐好转。17例患者在米卡芬净使用过程中未观察严重不良反应发生,也未因此而调整环胞素A治疗浓度。 结论 米卡芬净作为HSCT中SAP的备选用药之一是安全、有效的。【Abstract】 Objective Toinvestigatetheefficacyofmicafunginonsecondaryanti-fungalprophylaxis(SAP)inhematopoietiestemcelltransplantation(HSCT)recipientswhohadahistoryofantecedentinvasivefungalinfection(IFI)andtoobservethesafetyofmicafungin. Methods Thepatientswithhematologicaldiseases,whounderwentHSCTbetweenJanuary2009andJanuary2011,receivedourroutineconditioningregimen.Thepatients,whohadahistoryofantecedentIFI,weregivenbymicafunginforSAPfromthestartofconditioningchemotherapyuntiltheendoftheriskperiod. Results Therewere18patientshadahistoryofantecedentIFI.Theoverallefficacyofmicafunginwas17/18.OnepatientshadIFIonthe+27thdayduringSAP;onepatienthadbodycongestiverashaccompaniedwithpruritusinthepreventionperiod2daysaftertreatment,whogotbettergraduallyafterantianaphylaxistreatment.NopatientshadserveradversereactionandtheconcentrationofcyclosporineAwasnotchanged. Conclusion MicafunginasoneofdrugsforSAPIseffectiveandsafeforHSCT.

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