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目的探讨米卡芬净治疗儿童肺部侵袭性真菌感染的疗效。方法研究对象为2008年1月至2008年7月在哈尔滨市第一医院血液儿科临床诊断或拟诊为肺部侵袭性真菌感染(IPFI)患儿8例,在抗炎、对症和支持治疗的基础上,采用米卡芬净混悬剂(1～4mg/kg,每日1次)静点,同时配合两性霉素B去氧胆酸盐溶液(5mg/d,每日分2次)雾化吸入,之后采用伏立康唑片剂(4～8mg/kg,每日2次)序贯口服。疗程为2～12周,随访3～6个月。结果8例患儿全部为有效病例,其退热和临床症状改善时间为1～6d;除1例肺炎球菌肺炎并IPF(I临床诊断)患儿的显效时间为6周以外,其余7例IPFI(拟诊)患儿的显效时间为2～3周;所有病例在治疗的过程中,未发生不良反应;6例急性白血病的患儿均如期完成了以后的强化和巩固化疗;1例失访,另外7例未再复发。结论米卡芬净具有广谱、有效、安全和效价比高的优势,是IPFI经验性治疗的首选。
Objective To investigate the efficacy of micafungin in the treatment of children’s lung invasive fungal infection. Methods From January 2008 to July 2008 in Harbin First People’s Hospital, Department of Pediatrics, Department of Pediatrics, Department of Pediatrics, First Affiliated Hospital, Harbin Medical University, Harbin 150086, China. OBJECTIVE: To investigate the clinical data of eight children with pulmonary invasive fungal infection (IPFI) Based on the use of micafungin net suspension (1 ~ 4mg / kg, 1 times a day) at the same time, with the amphotericin B deoxycholate solution (5mg / d, 2 times a day) After inhalation, followed by voriconazole tablets (4 ~ 8mg / kg, 2 times a day) sequential oral. Treatment for 2 to 12 weeks, followed up for 3 to 6 months. Results All the 8 cases were effective cases, and the time for improvement of fever and clinical symptoms was 1 ~ 6 days. Except for 1 case of pneumococcal pneumonia and IPF (I clinical diagnosis), the effective time was 6 weeks, and the remaining 7 cases were IPFI (Proposed diagnosis) in children with effective time is 2 to 3 weeks; all cases in the course of treatment, no adverse reactions; 6 cases of children with acute leukemia were completed on schedule to strengthen and consolidate chemotherapy; 1 case of lost , Another 7 cases no recurrence. Conclusion Micafungin net with broad-spectrum, effective, safe and cost-effective advantages, is the preferred IPFI empirical treatment.