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[血液学患者及造血干细胞移植后的真菌感染：预防与治疗]

[Fungal infections in hematology patients and after blood stem cell transplantation: prophylaxis and treatment].

作者信息

Egerer G, Schmitt T

机构信息

Medizinische Klinik Abt. V Hämatologie, Onkologie und Rheumatologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland,

出版信息

Med Klin Intensivmed Notfmed. 2014 Oct;109(7):526-30. doi: 10.1007/s00063-013-0238-y. Epub 2013 Apr 12.

DOI:10.1007/s00063-013-0238-y
PMID:23576010
Abstract

Patients with prolonged neutropenia or immunosuppression after stem cell transplantation are at a high risk of developing invasive fungal infections. Antimycotic prophylaxis is used to reduce the associated morbidity and mortality. The following classes of antimycotic agents are currently available: azoles (e.g., fluconazole, itraconazole, posaconazole), echinocandins (caspofungin, micafungin), and amphotericin B.

摘要

干细胞移植后出现长期中性粒细胞减少或免疫抑制的患者发生侵袭性真菌感染的风险很高。抗真菌预防用于降低相关的发病率和死亡率。目前可用的抗真菌药物类别如下：唑类（如氟康唑、伊曲康唑、泊沙康唑）、棘白菌素类（卡泊芬净、米卡芬净）和两性霉素B。

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本文引用的文献

1
Low incidence of invasive aspergillosis in allogeneic stem cell transplant recipients receiving amphotericin B inhalation prophylaxis.
Transpl Infect Dis. 2012 Feb;14(1):24-32. doi: 10.1111/j.1399-3062.2011.00661.x. Epub 2011 Jul 12.
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Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america.抗菌药物在肿瘤中性粒细胞减少患者应用的临床实践指南：美国传染病学会 2010 年更新版。
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Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: a randomized, controlled trial.经验性抗真菌治疗与抢先抗真菌治疗用于高危、发热、中性粒细胞减少患者的随机对照试验
Clin Infect Dis. 2009 Apr 15;48(8):1042-51. doi: 10.1086/597395.
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Treatment of invasive fungal infections in cancer patients--recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO).癌症患者侵袭性真菌感染的治疗——德国血液学和肿瘤学会（DGHO）传染病工作组（AGIHO）的建议
Ann Hematol. 2009 Feb;88(2):97-110. doi: 10.1007/s00277-008-0622-5. Epub 2008 Oct 14.
7
Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.欧洲癌症研究与治疗组织/侵袭性真菌感染合作组和美国国立过敏与传染病研究所真菌病研究组（EORTC/MSG）共识组对侵袭性真菌病的修订定义。
Clin Infect Dis. 2008 Jun 15;46(12):1813-21. doi: 10.1086/588660.
8
Administration of micafungin as prophylactic antifungal therapy in patients undergoing allogeneic stem cell transplantation.米卡芬净用于异基因造血干细胞移植患者的预防性抗真菌治疗。
Int J Hematol. 2008 Jan;87(1):91-7. doi: 10.1007/s12185-007-0011-1. Epub 2007 Dec 11.
9
Safety of a weekly high dose of liposomal amphotericin B for prophylaxis of invasive fungal infection in immunocompromised patients: PROPHYSOME Study.每周高剂量脂质体两性霉素B预防免疫功能低下患者侵袭性真菌感染的安全性：PROPHYSOME研究。
Int J Antimicrob Agents. 2008 Feb;31(2):135-41. doi: 10.1016/j.ijantimicag.2007.10.001. Epub 2007 Dec 26.
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High-dose weekly liposomal amphotericin B antifungal prophylaxis following reduced-intensity conditioning allogeneic stem cell transplantation.减低预处理强度的异基因干细胞移植后高剂量每周一次脂质体两性霉素B抗真菌预防治疗
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