传染感染性疾病专栏

儿童急性白血病化疗后合并侵袭性真菌病的临床分析

  • 安琪 ,
  • 方代华 ,
  • 徐淑梅 ,
  • 玄承敏 ,
  • 金明卫 ,
  • 季强
展开
  • 徐州市儿童医院血液科(江苏徐州 221006)

收稿日期: 2016-01-15

  网络出版日期: 2016-01-15

Clinical analysis of invasive fungal disease after chemotherapy in childhood acute leukemia

  • AN Qi ,
  • FANG Daihua ,
  • XU Shumei ,
  • XUAN Chengmin ,
  • JIN Mingwei ,
  • JI Qiang
Expand
  • Department of Pediatrics, Xuzhou Children Hospital, Xuzhou 221006, Jiangsu, China

Received date: 2016-01-15

  Online published: 2016-01-15

摘要

 目的 探讨儿童急性白血病化疗后合并侵袭性真菌病(IFD)的临床特征、诊断及预后。方法 回顾性分析15 例急性白血病化疗后合并IFD 患儿的临床资料。结果 15 例患儿中确诊4 例,临床诊断8 例,拟诊3 例;感染部位,肺部8 例,肝脏3 例(其中1 例合并脾脏真菌感染),鼻窦2 例,真菌血症2 例。均予抗真菌治疗,完全缓解4 例,部分缓解2 例,总有效率40.0%(6/15);稳定1 例,疾病进展1 例,总无效率13.3%(2/15)。死亡7 例,病死率46.7%(7/15)。结论 儿童急性白血病化疗后合并IFD 以肺部真菌感染最常见,病原诊断困难,病情凶险,病死率高。

本文引用格式

安琪 , 方代华 , 徐淑梅 , 玄承敏 , 金明卫 , 季强 . 儿童急性白血病化疗后合并侵袭性真菌病的临床分析[J]. 临床儿科杂志, 2016 , 34(1) : 7 . DOI: 10.3969 j.issn.1000-3606.2016.01.002

Abstract

Objective To explore the clinical characteristics, diagnosis and prognosis of invasive fungal disease (IFD) after chemotherapy in children with acute leukemia (AL). Methods The clinical data of 15 AL pediatric patients combined with IFD were retrospectively analyzed. Results In the 15 pediatric patients, there were 4 cases (26.7%) of confirmed IFD, 8 cases (53.3%) of clinically diagnosed IFD and 3 cases (20.0%) of suspected IFD. The infection sites were lung (8 cases), liver (3 cases including 1 case combined with splenic fungal infection), sinus (2 cases) and fungemia (2 cases). All patients were given antifungal treatment. Four patients achieved complete response and 2 patients achieved partial response. The total effective rate was 40.0% (6/15). One patient was in stable condition and one patient was in progress. The total ineffective rate was 13.3% (2/15). Seven patients died and the total mortality was 46.7% (7/15). Conclusions The most common IFD in children with AL after chemotherapy is invasive pulmonary fungal infection. The pathological diagnosis of IFD is difficult. IFD is dangerous with high mortality.
文章导航

/