血液系统疾病患者的毛霉病：俄罗斯圣彼得堡的病例报告及前瞻性研究结果
Mucormycosis in haematological patients: case report and results of prospective study in Saint Petersburg, Russia.
作者信息
Klimko Nikolay N, Khostelidi Sofya N, Volkova Alisya G, Popova Marina O, Bogomolova Tatyana S, Zuborovskaya Ludmila S, Kolbin Aleksey S, Medvedeva Nadezhda V, Zuzgin Ilya S, Simkin Sergey M, Vasilyeva Nataliya V, Afanasiev Boris V
机构信息
I. Metchnikov North-Western State Medical University, St. Petersburg, Russia.
出版信息
Mycoses. 2014 Dec;57 Suppl 3:91-6. doi: 10.1111/myc.12247. Epub 2014 Sep 3.
We prospectively observed 36 haematological patients with mucormycosis from nine hospitals of St. Petersburg during 2004-2013. The most frequent underlying diseases were acute leukaemia (64%), and main risk factors were prolonged neutropenia (92%) and lymphocytopenia (86%). In 50% of the patients, mucormycosis was diagnosed 1-65 days after invasive aspergillosis. Main clinical form of mucormycosis was pulmonary (64%), while two or more organ involvement was noted in 50% of the cases. The most frequent aetiological agents of mucormycosis were Rhizopus spp. (48%). Twelve-week survival rate was 50%. Combination therapy (echinocandins + amphotericin B forms) and recovery from the underlying disease significantly improved the survival rate.
2004年至2013年期间，我们对圣彼得堡9家医院的36例患有毛霉病的血液学患者进行了前瞻性观察。最常见的基础疾病是急性白血病（64%），主要危险因素是长期中性粒细胞减少（92%）和淋巴细胞减少（86%）。50%的患者在侵袭性曲霉病后1至65天被诊断出毛霉病。毛霉病的主要临床形式是肺部（64%），50%的病例出现两个或更多器官受累。毛霉病最常见的病原体是根霉属（48%）。12周生存率为50%。联合治疗（棘白菌素+两性霉素B制剂）和基础疾病的缓解显著提高了生存率。
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