摘要目的 研究血液系统恶性肿瘤患者中预防性使用泊沙康唑抗真菌治疗的有效性和安全性.方法 回顾性分析2014年2月至2017年4月上海瑞金医院102例血液系统恶性肿瘤患者化疗期间预防性使用泊沙康唑抗真菌治疗的效果,采用Spearman进行相关性分析.结果 102例血液系统恶性肿瘤患者化疗期间,给予泊沙康唑预防性治疗后,2例(1.96%)发生侵袭性真菌感染.2例患者治疗期间发生死亡,但与泊沙康唑治疗无关.11例患者因不良反应停用泊沙康唑,不良反应导致的停药率为10.8%;2例侵袭性真菌感染抗真菌治疗失败和1例未确诊侵袭性真菌病患者停用泊沙康唑,泊沙康唑整体停药率为13.7%(14/102).泊沙康唑使用时间与住院时间、中性粒细胞缺乏时间均无相关性(rs=-0.02,P=0.853;rs=0.167,P=0.113),住院时间与中性粒细胞缺乏时间呈正相关(rs=0.448,P=0.000).结论 泊沙康唑用于血液系统恶性肿瘤患者侵袭性真菌病的预防性治疗,有效性和安全性均较佳.

abstractsObjective To observe the effec t and safety of posaconzole in prophylactic antifungal treatment of high-risk patients with hematological malignancies. Methods The effect of posaconzole on prevention of invasive fungal disease (IFD) during chemotherapy in 102 patients with hematological malignancies in Shanghai Ruijin Hospital from February 2014 to April 2017 were analyzed retrospectively. The correlation analysis was carried out by Spearman analysis. Results A total of 102 patients were included, and only 2 (1.96%) patients had IFD. 2 patients died because of development of hematological malignancies. 11 (10.8%) patients had to discontinuation of posaconzole because of sever adverse events. Two patients with IFD and 1 case of undiagnosed IFD had to discontinue posaconzole. The total rate of discontinuation was 13.7 % (14/102). There was no correlation between the time of using pothiazol and the time of hospitalization (rs= -0.02, P= 0.853) and the time of neutrophilic deficiency (rs= 0.167, P= 0.113), but the time of hospitalization was positively correlated with the time of neutrophilic deficiency (rs = 0.448, P=0.000). Conclusion Posaconzole could effectively and safely prevent IFD in patients with hematological malignancies.