论文部分内容阅读
目的评价并对比恶性血液病患者应用泊沙康唑与伊曲康唑预防侵袭性真菌病(IFD)的效果和安全性。方法采用前瞻性随机对照研究,具有高危真菌感染因素的恶性血液病患者分为两组,泊沙康唑组予泊沙康唑200 mg,po,tid;伊曲康唑组予伊曲康唑200 mg,po,bid。两组均服药持续至粒细胞缺乏恢复或需要更换抗真菌药物。观察两组预防效果以及安全性。结果共有55例患者完成研究,泊沙康唑组25例,伊曲康唑组30例。泊沙康唑组和伊曲康唑组出现IFD的比例分别为4%(1/25)和23%(8/30),组间有显著差异(P<0.05);泊沙康唑组换用一线抗真菌治疗的比例低于伊曲康唑组(20%vs.47%,P<0.05),且无真菌感染事件生存率明显高于伊曲康唑组(80%vs.63%,P<0.05)。两组不良反应均较少。结论对于具有高危真菌感染因素的恶性血液病患者,与伊曲康唑相比,泊沙康唑可以更加有效地预防IFD的发生,且具有良好的安全性。
Objective To evaluate and compare the efficacy and safety of posaconazole and itraconazole in the prevention of invasive fungal diseases (IFD) in patients with hematologic malignancies. Methods A prospective randomized controlled study was conducted in patients with hematologic malignancies with high-risk fungal infection. The patients were divided into two groups: posaconazole 200 mg, po, tid; and itraconazole vs itraconazole 200 mg, po, bid. Both groups continued their medication until the agranulocytosis recovered or an antifungal drug was needed. Observe the preventive effect and safety of two groups. RESULTS: A total of 55 patients completed the study, 25 in the posaconazole group and 30 in the itraconazole group. The percentage of IFD in the posaconazole group and the itraconazole group was 4% (1/25) and 23% (8/30), respectively, with significant difference (P <0.05); the posaconazole group The proportion of patients treated with first-line antifungal agents was lower than that of itraconazole group (20% vs. 47%, P <0.05), and the survival rate of patients without fungal infection was significantly higher than that of itraconazole group (80% vs.63% P <0.05). Two groups of adverse reactions are less. Conclusion Posaconazole can prevent IFD more effectively than itraconazole in patients with hematologic malignancies with high-risk fungal infection and has good safety.