泊沙康唑预防造血干细胞移植患者侵袭性真菌病临床观察云南第一.DOC

通信作者：杨艳梅，Email:ynthyym@163.com 泊沙康唑预防造血干细胞移植患者侵袭性真菌病临床观察 云南省第一人民医院 杨艳梅 史克倩 杨同华 陆智祥 辜学忠 陈枫煜 ,昆明 650032 摘要 目的 观察泊沙康唑预防恶性血液病患者造血干细胞移植（HSCT）后侵袭性真菌病的临床效果和安全性。方法 收集我院血液科2015年3月-2016年2月HSCT 18例，2例移植前有肺部真菌病史，从预处理开始口服泊沙康唑600mg/天,至中性粒细胞恢复，之后异基因造血干细胞移植患者改为伊曲康唑或伏立康唑口服至+75天。结果 18例患者未发生突破性真菌感染，在泊沙康唑使用过程中未观察到严重毒副反应发生，到随访结束时，16例存活。结论 泊沙康唑对预防恶性血液病患者造血干细胞移植后侵袭性真菌病是安全、有效的。 关键词 泊沙康唑；侵袭性真菌病；预防；造血干细胞移植 Clinical observation of posaconazole on prevention invasive fungal disease in patients with hematopoietic stem cell transplantation YANG Yan- mei, SHI Ke- qian,YANG Tong- hua, LU Zhi -xiang, GU Xue -zhong, CHEN Feng- yu, Department of Hematology, The First Peoples Hospital of Yunnan Province,Kunming 650032,China. Abstrac Objective To observe the efficiency and safety of posaconazole on prevention invasive fungal disease in patients with hematopoietic stem cell transplantation （HSCT）. Methods From March 2015 -2016 February ,18 patients who receiveed posaconazole prevented invasive fungal disease in the first peoples Hospital of Yunnan Province after HSCT were analyzed retrospectively,2patients were pulmonary fungal disease before HSCT, posaconazole 600mg/day were to be taken orally beganning from pretreatment,to neutrophil recovery,afterward， itraconazole or voriconazole were to be taken orally to +75 days in patients with allogeneic hematopoietic stem cell transplantation. Results No breakthrough fungal infection occurred in 18 patients,no serious side effects were observed during the use of posaconazole, HYPERLINK /finally finally 16 patients survival. Conclusion Posaconazole prevented invasive fungal disease after hematopoietic stem cell transplantation is safty and effective. Key words posaconazole; invasive fungal disease; prevent; hematopoietic stem cell transplantation. 造血干细胞移植（HSCT）是当今白血病、淋巴瘤等血液系统恶性肿瘤重要和有效的治疗手段之一，造血干细胞移植患者因接受大剂量的放疗、化疗使中性粒细胞减少，免疫抑制剂及广谱抗生素的使用、粘膜炎的发生、导管的留置、移植物抗宿主病的发生等使真菌感染的机会大大增加,移植后真菌感染仍是患者死亡的重要原因，尤其是侵袭性真菌病（IFD），