关键词: 恶性血液病, 侵袭性真菌病, 疗效, 危险因素, 合理用药

Abstract:

Objective To investigate clinical features and pathogenic distributions of invasive fungal diseases in patients with hematologic malignancies,analyze risk factors of the therapeutic effect and the usage of antifungal agents in order to provide reference for clinical diagnosis and treatment.Methods The clinical data of 327 cases of invasive fungal diseases in patients with hematologic malignancies,who were treated in the hospital from Jan 2014 to Dec 2015,were retrospectively analyzed,and the pathogenic distributions,infectious sites,therapeutic effect,risk factors and use of antifungal agents were statistical analyzed by the use of software SPSS 21.0.Results Totally 410 fungal strains were isolated from the 327 patients,including Candida albicans (80.73%) and Aspergillus (9.76%);and the lung was the main infection sites (80.81%).The total cure rate was 61.77%,and the mortality was 12.84%.The therapeutic effect was positively correlated with the patients treated with glucocorticoid and more than three broad-spectrum antibiotics;while there was a negative correlation between the age of patients and therapeutic effect.The irrational use of antifungal agents included lack of loading dose,dosage and drug interaction.Conclusion The Candida albicans is the predominant species of pathogens causing invasive fungal infections in patients with hematologic malignancies.The main risk factors are aging and application of glucocorticoid and broad-spectrum antibiotics.It is important to focus on the elderly patients,and to strengthen the reasonable applications of glucocorticoid and broad-spectrum antibiotics.The unreasonable use of antifungal agents is relatively common.Usage and dosage,and drug interaction should be noted,and the supervision of antifungal agents use should be strengthened.

Key words: hematological malignancies, invasive fungal disease, therapeutic effects, risk factor, rational drug use