CAJ | 학술논문

目的评价伊曲康唑口服液对预防急性白血病化疗后粒细胞缺乏(粒缺)期侵袭性真菌感染(IFI)的疗效.方法回顾性分析2008年1月—2010年12月南方医院血液科收集的急性白血病化疗后伴粒缺的136例患者,将其分为伊曲康唑组(67例)和对照组(69例).伊曲康唑组中急性非淋巴细胞白血病( ANLL)36例,急性淋巴细胞白血病(ALL)31例；对照组中ANLL 30例,ALL 38例,l例为急性双表型白血病(BAL).伊曲康唑组化疗后粒缺期间给予伊曲康唑口服液,持续至中性粒细胞计数＞0.5 ×l09/L,或是体温正常且影像学无IFI改变时停用.采用SPSS 13.0软件分析两组IFI的发生率及临床特点.计数资料采用Pearsonx2检验,正态分布的计量资料采用t检验,偏态分布的数据采用Mann-Whitney U检验.结果伊曲康唑组12例发生IFI,发生率为17.9％(12/67),对照组32例发生IFI,发生率为46.4％( 32/69),两组IFI发生率比较差异有统计学意义(x2=12.59,P＜0.01).伊曲康唑组中ANLL患者IFI发生率(6/36,16.7％)低于对照组中ANLL患者的发生率(17/30,56.7％)(x2=11.53,P＜0.01).伊曲康唑组女性患者IFI发生率(3/35,8.6％)低于男性(9/32,28.1％)(x2 =4.35,P＜0.05),同时也低于对照组中女性患者IFI发生率(17/38,44.7％)(x2=11.98,P＜0.01).结论急性白血病化疗后粒缺期患者预防性口服伊曲康唑可以有效降低IFI的发生,对于急性非淋巴细胞白血病女性患者,疗效更加显著.
목적 평개이곡강서구복액대예방급성백혈병화료후립세포결핍(립결)기침습성진균감염(IFI)적료효.방법 회고성분석2008년1월—2010년12월남방의원혈액과수집적급성백혈병화료후반립결적136례환자,장기분위이곡강서조(67례)화대조조(69례).이곡강서조중급성비림파세포백혈병( ANLL)36례,급성림파세포백혈병(ALL)31례；대조조중ANLL 30례,ALL 38례,l례위급성쌍표형백혈병(BAL).이곡강서조화료후립결기간급여이곡강서구복액,지속지중성립세포계수＞0.5 ×l09/L,혹시체온정상차영상학무IFI개변시정용.채용SPSS 13.0연건분석량조IFI적발생솔급림상특점.계수자료채용Pearsonx2검험,정태분포적계량자료채용t검험,편태분포적수거채용Mann-Whitney U검험.결과 이곡강서조12례발생IFI,발생솔위17.9％(12/67),대조조32례발생IFI,발생솔위46.4％( 32/69),량조IFI발생솔비교차이유통계학의의(x2=12.59,P＜0.01).이곡강서조중ANLL환자IFI발생솔(6/36,16.7％)저우대조조중ANLL환자적발생솔(17/30,56.7％)(x2=11.53,P＜0.01).이곡강서조녀성환자IFI발생솔(3/35,8.6％)저우남성(9/32,28.1％)(x2 =4.35,P＜0.05),동시야저우대조조중녀성환자IFI발생솔(17/38,44.7％)(x2=11.98,P＜0.01).결론 급성백혈병화료후립결기환자예방성구복이곡강서가이유효강저IFI적발생,대우급성비림파세포백혈병녀성환자,료효경가현저.
Objective To evaluate the efficacy of itraconazole oral solution for prevention of invasive fungal infection ( IFI ) in neutropenic patients with acute leukemia after chemotherapy.Methods Clinical data of 136 neutropenic patients with acute leukemia after chemotherapy at the Department of Hematology,Nanfang Hospital from January 2008 to December 2010 were retrospectively analyzed.Patients were divided into itraconazole group ( n =67 ) and control group ( n =69).There were 36 patients with acute nonlymphocytic leukemia ( ANLL),31 with acute lymphoblastic leukemia (ALL) in itraconazole group;while in control group,there were 30 patients with ANLL,38 with ALL and 1 with biphenotypic acute leukaemia (BAL).Patients in itraconazole group received intraconazole after chemotherapy until the neutrophil count was increased to 0.5 × 109/L or the body temperature returned to normal and without any imaging evidence of IFI.The incidence of IFI and clinical features were compared between the groups using SPSS 13.0 software.Pearson x2 test was used for nominal variables,for measurement data,t (normal distribution) or Mann-Whitney U (skewed distribution) test were used.Results There were 12 cases ( 17.9％ ) suffering from IFI in itraconazole group and 32 cases (46.4％) in the control group (x2 =12.59,P ＜ 0.01 ).For ANLL patients,the incidence of IFI in itraconazole group was significantly lower than that in control group ( 16.7％ vs.56.7％,x2 =11.53,P ＜0.01 ).In itraconazole group,the incidence of IFI in female patients was significantly lower than that in male patients ( 8.6％ vs.28.1％,x2 =4.35,P ＜0.05 ).And for the female patients,the incidence of IFI in itraconazole group was significantly lower than thatin the control group (8.6％ vs.44.7％,x2 =11.98,P＜0.01).Conclusion Itranconzole oral solution can effectively prevent IFI in neutropenic patients with acute leukemia after chemotherapy,especially for the female patients with ANLL.