航空航天医学杂志
航空航天醫學雜誌
항공항천의학잡지
Journal of Aerospace Medicine
2015年
11期
1318-1320
,共3页
伊曲康唑%急性髓系白血病%肺部侵袭性真菌感染%血药浓度%预防
伊麯康唑%急性髓繫白血病%肺部侵襲性真菌感染%血藥濃度%預防
이곡강서%급성수계백혈병%폐부침습성진균감염%혈약농도%예방
itraconazole%acute myeloid leukemia%invasive pulmonary fungal infection%blood drug concentration%prevention
目的 探讨伊曲康唑不同给药方案用于急性髓系白血病患者肺部侵袭性真菌感染( IFI)的临床效果及安全性. 方法 选取血液科2013年1月~2014年12月收治的行诱导化疗和巩固化疗的35例急性髓系白血病患者为研究对象,35例患者共进行97例次化疗,将97例次随机分为口服液组48例次和贯序组49例次,口服液组患者给予伊曲康唑口服液预防肺部侵袭性真菌感染,贯序组患者前2天给予伊曲康唑静脉给药,之后给予伊曲康唑口服液维持,最长用药均为6周,监测两组患者血药浓度,观察两组患者IFI预防有效率、不良反应及严重程度. 结果 贯序组患者IFI预防有效率(93.9%)显著高于口服液组(79.2%)(χ2 =4.251 P=0.033);贯序组伊曲康唑稳态血药浓度(698.2 ±99.5)ng/mL显著高于口服液组(573.5 ±78.3)ng/mL(t=6.850 P<0.001);贯序组患者伊曲康唑血药浓度达到500 ng/mL的时间( 3.4 ±1.0 )天,明显低于口服液组( 7.8 ±2.2 )天( t=12.726 P<0.001 ). 贯序组患者维持稳态血药浓度的时间( 11.2 ±2.9 )天明显高于口服液组( 6.7 ±1.6 ) ( t=9.836 P<0.001 );两组患者因不良反应退出研究比例( 14.6% vs.18.4%)差异无统计学意义(χ2 =0.252 P=0.616 ). 结论 伊曲康唑预防急性髓性白血病患者粒细胞缺乏期侵袭性真菌感染的效果与血药浓度密切相关,静脉±口服液的贯序方案效果优于单纯口服液方案.
目的 探討伊麯康唑不同給藥方案用于急性髓繫白血病患者肺部侵襲性真菌感染( IFI)的臨床效果及安全性. 方法 選取血液科2013年1月~2014年12月收治的行誘導化療和鞏固化療的35例急性髓繫白血病患者為研究對象,35例患者共進行97例次化療,將97例次隨機分為口服液組48例次和貫序組49例次,口服液組患者給予伊麯康唑口服液預防肺部侵襲性真菌感染,貫序組患者前2天給予伊麯康唑靜脈給藥,之後給予伊麯康唑口服液維持,最長用藥均為6週,鑑測兩組患者血藥濃度,觀察兩組患者IFI預防有效率、不良反應及嚴重程度. 結果 貫序組患者IFI預防有效率(93.9%)顯著高于口服液組(79.2%)(χ2 =4.251 P=0.033);貫序組伊麯康唑穩態血藥濃度(698.2 ±99.5)ng/mL顯著高于口服液組(573.5 ±78.3)ng/mL(t=6.850 P<0.001);貫序組患者伊麯康唑血藥濃度達到500 ng/mL的時間( 3.4 ±1.0 )天,明顯低于口服液組( 7.8 ±2.2 )天( t=12.726 P<0.001 ). 貫序組患者維持穩態血藥濃度的時間( 11.2 ±2.9 )天明顯高于口服液組( 6.7 ±1.6 ) ( t=9.836 P<0.001 );兩組患者因不良反應退齣研究比例( 14.6% vs.18.4%)差異無統計學意義(χ2 =0.252 P=0.616 ). 結論 伊麯康唑預防急性髓性白血病患者粒細胞缺乏期侵襲性真菌感染的效果與血藥濃度密切相關,靜脈±口服液的貫序方案效果優于單純口服液方案.
목적 탐토이곡강서불동급약방안용우급성수계백혈병환자폐부침습성진균감염( IFI)적림상효과급안전성. 방법 선취혈액과2013년1월~2014년12월수치적행유도화료화공고화료적35례급성수계백혈병환자위연구대상,35례환자공진행97례차화료,장97례차수궤분위구복액조48례차화관서조49례차,구복액조환자급여이곡강서구복액예방폐부침습성진균감염,관서조환자전2천급여이곡강서정맥급약,지후급여이곡강서구복액유지,최장용약균위6주,감측량조환자혈약농도,관찰량조환자IFI예방유효솔、불량반응급엄중정도. 결과 관서조환자IFI예방유효솔(93.9%)현저고우구복액조(79.2%)(χ2 =4.251 P=0.033);관서조이곡강서은태혈약농도(698.2 ±99.5)ng/mL현저고우구복액조(573.5 ±78.3)ng/mL(t=6.850 P<0.001);관서조환자이곡강서혈약농도체도500 ng/mL적시간( 3.4 ±1.0 )천,명현저우구복액조( 7.8 ±2.2 )천( t=12.726 P<0.001 ). 관서조환자유지은태혈약농도적시간( 11.2 ±2.9 )천명현고우구복액조( 6.7 ±1.6 ) ( t=9.836 P<0.001 );량조환자인불량반응퇴출연구비례( 14.6% vs.18.4%)차이무통계학의의(χ2 =0.252 P=0.616 ). 결론 이곡강서예방급성수성백혈병환자립세포결핍기침습성진균감염적효과여혈약농도밀절상관,정맥±구복액적관서방안효과우우단순구복액방안.
Objective To explore clinical efficacy and safety of different dosing itraconazole regimens in prevention of pulmonary IFI in acute myeloid leukemia .Methods 35 cases of acute myeloid leukemia patients underwent chemothera-py and consolidation chemotherapy of January 2013 to December 2014 in our hospital were selected as study objects , all cases with a total of 97 case time of chemotherapy, which were randomly assigned to oral liquid group (48 cases )and se-quential treatment group (49 cases), oral liquid group were treated with itraconazole oral liquid for prevention of pulmo-nary IFI, sequential treatment was given itraconazole intravenously for the first 2 days ,after which maintained with itra-conazole oral liquid ,all cases with the longest administration for 6 weeks, blood itraconazole concentration was monitored during treatment , and effective prevention ratio for IFI , adverse reactions and severity were noted .Results Sequential treatment group whose IFI prevention efficiency (93.9%) was significantly higher than oral liquid group (79.2%) (χ2=4.251 P =0.033 ); Sequential treatment group whose steady -state blood itraconazole concentration ( 698.2 ± 99.5)ng/mL was significantly higher than oral liquid group (57.35 ±78.3)ng/mL (t=6.850 P<0.001);Patients in sequential treatment group whose time course of blood itraconazole concentration reached to 500 ng/mL (3.4 ±1.0)d was significantly lower than oral liquid group (7.8 ±2.2)d (t=12.726 P<0.001).Sequential treatment group who maintained steady blood itraconazole concentration course (11.2 ±2.9)d was significantly higher than oral liquid group (6.7 ±1.6) (t=9.836 P<0.001).Two groups whose proportion withdrew from the study (14.6%vs.18.4%)due to adverse reactions with no statistical differences (χ2 =0.252 P=0.616 ) .Conclusions Clinical efficacy of itraconazole in preventive of pulmonary IFI of acute myeloid leukemia with granulocyte deficiency stage is closely related to blood drug concentration , efficacy of intravenous plus oral liquid regimen is superior to simple oral liquid regimen .
