摘要
目的探讨卡泊芬净在临床上治疗糖尿病患者侵入性真菌感染(IFI)的疗效及安全性评估,以指导临床对糖尿病患者侵入性真菌感染的控制及治疗。方法回顾性分析2010年5月-2012年6月内分泌科接受过卡泊芬净治疗的糖尿病IFI患者临床资料。结果共有30例糖尿病IFI患者接受了卡泊芬净治疗;其中25例确诊为IFI患者,包括13例假丝酵母菌菌血症和8例肺IFI;5例疑似糖尿病IFI患者,病原菌不明;30例患者中共分离出真菌25株,其中主要为假丝酵母菌属和曲霉菌属,白色假丝酵母菌14株,高达56.0%;分离标本主要来自于血液和支气管灌洗液,卡泊芬净中位疗程为(21.4±12.4)d;30例可评估患者中,痊愈12例占40.0%,显效8例占26.7%,总有效率为66.7%,进步4例;死亡6例,病死率达20.0%;治疗过程中未发现与卡泊芬净引起的不良反应。结论卡泊芬净在治疗糖尿病患者IFI是安全且有效,值得进一步在临床验证使用。
OBJECTIVE To investigate efficacy and safety of caspofung in treatment of invasive fungal infections （IFI） in diabetes patients so as to provide guidance for the clinical control and treatment of IFI in the diabetes patients. METHODS The clinical data of 30 cases diabetes patients who received treatment of IFI with caspofungin in the endocrinology department from May 2010 to Jun 2012 were retrospectively analyzed. RESULTS Amung 30 diabetes patients who received the treatment of IFI with caspofungi, there were 25 cases with confirmed IFI, including 13 cases of candidiasis bacteremia and 8 cases of pulmonary IFI; there were 5 cases with suspected IFI, without pathogens being detected. Totally 25 strains of fungi were isolated from the 30 patients, among which Candida and Aspergillus were dominant; there were 14 （56.0%） strains of Candida albicans. The blood and bronchoalveolar lavage fluid were the main specimen sources, the median treatment course of caspofungi was （21.4±12.4）d. Of 30 cases with the information available, 12 （40.0%） cases were cured, 8 （26.7%） cases were markedly improved, and the overall effective rate was 66. 7%, 4 cases improved; 6 cases died with the mortality of 20. 0%. No adverse effects induced by caspofungi occurred during the treatment. CONCLUSION Caspofungin is safe and effective in treatment of IFI in the diabetes patients , it is worthy to be used in clinical trial.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第22期5533-5534,5574,共3页
Chinese Journal of Nosocomiology
基金
武汉市临床医学科研基金项目(WX13D09)
