Analysis Of Diagnosis And Treatment Of Invasive Fungal Infections In Patients With Hematologic Malignancy

Objective To analyze retrospectively the manifestations and compare the efficacy and safety of micafugin, Voriconazol and Liposomal Amphotericin B in the treatment of invasive fungal infections in patients with hematologic malignancy.Methods Cluster sampling was used in this research. All the inpatients with hematologic malignancy who underwent invasive fungal infections and given micafungin, Voriconazol or Liposomal Amphotericin B therapy in our hospital from January 2006 to February 2008 were involved in this research. Investigate the high risk factors,manifestations,symptoms, imaging and compare the efficacy and safety after the treatment of micafungin, Voriconazol and Liposomal Amphotericin B.Results Eighty-six patients were involved.There was no significant difference in the common data of the patients in the three groups. The high risk factors of fungal infection included: granulocytopenia after chemotherapy, long- term usage of immunosuppressive agents,usage of steroid,bone marrow transplantation,usage of venous cannula.The manifestations and symptoms of invasive fungal infection have no specificity.Lung and gastrointestinal tract were the most common positions involved. The total effective rate was 61.63%,and the total adverse reaction rates were 44.19%.For caspofungin group(22 cases), Voriconazol group(31 cases) and liposomal amphotercin B group(33 cases) the overall effective rates were 63.64%,64.52% and 57.58% respectively.The adverse reaction rates were 27.28%, 22.58% and 75.76% respectively. There were no significant difference in the overall effective rates between three groups,but the adverse reaction occurrence of caspofungin group and Voriconazol group were lower than liposomal amphotericin B group.And there was no significant difference between the effective rates of the patients with clinical diagnosis and with recommended diagnosis.Condusion 1.The manifestations and symptoms of invasive fungal infection have no specificity. CT scan,immunoassays and molecular techniques should be highly valued in order to improve the accuracy rate of invasive fungal infections.2.Micafungin and Voriconazol is as effective as liposomal amphoteriein B but with fewer adverse reactions in the treatment of fungal infection in patients with hematologic diseases.