Yi Xue-Lan, Mao Qing, Jiang Yan, Guo Xiu-Bing, Chen Yan
The Second Department of Pediatrics, The Affiliated Hospital of Zunyi Medical College, Guizhou Children's Hospital, Zunyi 563000, Guizhou Province, China.
The Second Department of Pediatrics, The Affiliated Hospital of Zunyi Medical College, Guizhou Children's Hospital, Zunyi 563000, Guizhou Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Dec;25(6):1627-1630. doi: 10.7534/j.issn.1009-2137.2017.06.008.
To study the clinical efficacy of amphotericin B and voriconazole in the treatment of invasive fungal infection in children with acute lymphoblastic leukemia(ALL) during chemotherapy.
The clinical data of 214 patients with acute lymphoblastic leukemia admitted in our hospital from March 2014 to February 2017 was retrospectively analyzed. Among them 65 patients had invasive fungal infection (IFI) during the chemotherapy period, out of them 35 patients treated with voriconazole were enrolled in group A; anather 30 patients treated with amphotericin B were enrolled in group B. The clinical factors that affected the incidence of IFI was statistically analyzed. And the efficacy and adverse reactions in children with ALL were compared after treatment for 8 weeks.
The incidence of IFI in children with ALL in this study was 30.37%, and was related with the duration of hospitalization and the level of neutrophil deficiency (P<0.05). The total effective rates of group A and group B were 72.28% and 43.33%, respectively, their difference was statistically significant between 2 group (P<0.05). The incidence of renal function impairment, digestive dysfunction and neurotoxicity were 8.57%, 5.71% and 5.71% in children with ALL treated with voriconazole respectively, which were lower than those in children treated with amphotericin B (P<0.05). The score index of Physical health, energy state, emotion control and overall health in group A were significantly higher than those in B group, and the difference was statistically significant (P<0.05).
The occurrence of IFI in children with ALL relats with the time of hospitalization and the level of neutrophils. The clinical effect of voriconazole is better, and the incidence of adverse reactions can be reduced, suggesting important clinical significance.
研究两性霉素B和伏立康唑治疗急性淋巴细胞白血病（ALL）患儿化疗期间侵袭性真菌感染的临床疗效。
回顾性分析2014年3月至2017年2月我院收治的214例急性淋巴细胞白血病患者的临床资料。其中65例患者在化疗期间发生侵袭性真菌感染（IFI），将其中35例接受伏立康唑治疗的患者纳入A组；另30例接受两性霉素B治疗的患者纳入B组。对影响IFI发生率的临床因素进行统计学分析。并比较治疗8周后ALL患儿的疗效及不良反应。
本研究中ALL患儿IFI发生率为30.37%，与住院时间和中性粒细胞缺乏水平有关（P<0.05）。A组和B组的总有效率分别为72.28%和43.33%，两组差异有统计学意义（P<0.05）。伏立康唑治疗的ALL患儿肾功能损害、消化功能障碍和神经毒性的发生率分别为8.57%、5.71%和5.71%，均低于两性霉素B治疗的患儿（P<0.05）。A组的身体健康、能量状态、情绪控制和总体健康评分指数均显著高于B组，差异有统计学意义（P<0.05）。
ALL患儿IFI的发生与住院时间和中性粒细胞水平有关。伏立康唑的临床效果较好，可降低不良反应的发生率，具有重要的临床意义。
