CAJ | 학술논문

目的研究150 mg/d米卡芬净治疗急性白血病患者合并侵袭性真菌感染(IFI)的疗效和安全性.方法 133例急性白血病合并IFI患者,以米卡芬净150 mg/d连续治疗14 d,在治疗第(7±2)天及第(14±2)天评估临床疗效及真菌学疗效,并记录药物不良反应.正态分布数据比较采用方差分析,非正态分布数据采用Wilcoxon秩和检验.结果 133例急性白血病合并IFI患者中,116例完成了14 d的米卡芬净治疗.急性白血病合并IFI患者(14±2)d 临床疗效总体改善率为94.8%,真菌学疗效总体清除率为75.0%,其中对念珠菌的清除率为82.9%,对曲霉菌的清除率为66.7%,其他真菌的清除率为55.6%,两者均明显好于(7±2) d(83.6%,21.4%),差异有统计学意义(X2=6.060、34.416,均P<0.05).临床疗效与年龄、性别、IFI诊断、白血病类型及是否合并用药无关(X2=26.541,P<0.05).133例患者的药物相关不良反应发生率为3%,主要为皮疹3例、腹泻1例,除1例因皮疹严重而停药外,其余均可耐受.结论 150 mg/d米卡芬净治疗14 d对急性白血病合并IFI患者具有良好的疗效及安全性.
목적 연구150 mg/d미잡분정치료급성백혈병환자합병침습성진균감염(IFI)적료효화안전성.방법 133례급성백혈병합병IFI환자,이미잡분정150 mg/d련속치료14 d,재치료제(7±2)천급제(14±2)천평고림상료효급진균학료효,병기록약물불량반응.정태분포수거비교채용방차분석,비정태분포수거채용Wilcoxon질화검험.결과 133례급성백혈병합병IFI환자중,116례완성료14 d적미잡분정치료.급성백혈병합병IFI환자(14±2)d 림상료효총체개선솔위94.8%,진균학료효총체청제솔위75.0%,기중대념주균적청제솔위82.9%,대곡매균적청제솔위66.7%,기타진균적청제솔위55.6%,량자균명현호우(7±2) d(83.6%,21.4%),차이유통계학의의(X2=6.060、34.416,균P<0.05).림상료효여년령、성별、IFI진단、백혈병류형급시부합병용약무관(X2=26.541,P<0.05).133례환자적약물상관불량반응발생솔위3%,주요위피진3례、복사1례,제1례인피진엄중이정약외,기여균가내수.결론 150 mg/d미잡분정치료14 d대급성백혈병합병IFI환자구유량호적료효급안전성.
Objective To evaluate the efficacy and safety of micafungin in the treatment of invasive fungal infections (IFI) in patients with acute leukemia.Methods A total of 133 IFI patients with acute leukemia received micafungin 150 mg once daily for 14 days.The clinical and mycological efficacies were evaluated on (7±2) days and(14±2) days of treatment.Meanwhile,the adverse events were recorded.The normally distributed data was compared using analysis of variance and nonnormal distributed data was analyzed using Wilcoxon rank-sum test.Results Among 133 IFI patients with acute leukemia,116 finished the 14-day micafungin treatment.The total clinical efficacy was 94.8% and the total mycological efficacy was 75.0% at (14±2) days of treatment.The fungus eliminate rates were 82.9%,66.7% and 55.6% against Monilia,Aspergillus and others,respectively.The clinical and mycological efficacies of (14±2)-day treatment were both higher than those of (7±2)-day treatment(X2=6.060,34.416.both P<0.05).The clinical efficacy was not related with age,sex,IFI diagnose,types of leukemia and combinative drugs (X2=26.541,P<0.05).The incidence of drug-related adverse events of micafungin was 3%among 133 patients,which included skin rash in 3 eases, diarrhea in 1 case. Only one case was discontinued because of severe skin rash and micafungin was well tolerant in other patients. Conclusion Treatment of micafungin 150 mg daily for 14 days is effective and safe in IFI patients with acute leukemia.