摘要
目的探讨异基因造血干细胞移植(allo-HSCT)后患者发生肺部真菌感染的发病原因及防治措施。方法对6例发生肺部真菌感染的allo-HSCT后患者的临床表现,影像学,微生物学,血象,免疫抑制剂和糖皮质激素的使用以及免疫功能状态,有无移植物抗宿主病(GVHD)和广谱抗生素的应用情况进行了临床统计和分析。结果6例患者均有体温>38℃;不同程度的呼吸道症状;肺部CT除曲霉菌感染有典型表现外一般无特殊改变。患者多有白细胞和中性粒细胞减少、使用免疫抑制剂和糖皮质激素及发生慢性GVHD,加上广谱抗生素的应用使得真菌感染率增加。4例治愈,2例死亡。结论对于allo-HSCT后具有真菌感染高危因素患者应给予高度重视,治疗真菌同时可给予增强免疫功能的治疗。
Objective This study was to evaluate the etiological factors,prophylaxis and therapy of pulmonary fungal infection after allogeneic haemopoietic stem cell transplantation(allo-HSCT).Methods 6 patients after allo-HSCT with pulmonary fungal infection were involved and analyzed. Results Temperature of all patients exceeded 38℃,and they all had respiratory manifestation; pulmonary CT had no typical manifestation except Aspergillus cases. Leucocytopenia and neutrocytopenia,taking immunodepressant and glucocorticoid,and the cGVHD application broad-spectrum antibiotic in creased,the incidence of pulmonary fungal infection. Amphotericin B was used for Aspergillus cases,the rest used Itraconazole,caspofungin was used to the refractory cases. 4 cases was cured and 2 was dead. Conclusion We should pay more attention to the patients after allo-HSCT with the high risk of pulmonary fungal infection,and try to enhance immune function when the pulmonary fungal infection therapy is undertaken.
出处
《中国临床保健杂志》
CAS
2007年第1期54-56,共3页
Chinese Journal of Clinical Healthcare
关键词
肺疾病
真菌性
干细胞移植
Lung diseases,fungal
Stem cell transplantation
