【摘要】 目的探讨实体肿瘤合并侵袭性真菌感染患者的特点、临床表现、诊治及预后。方法对1995年1月至2005年8月间在北京协和医院住院治疗的所有实体肿瘤合并侵袭性真菌感染的患者进行回顾性分析。结果10年间共有37例实体肿瘤患者合并侵袭性真菌感染。感染部位:肺部34例,胆道1例,泌尿系4例,真菌血症3例。37例患者中共分离培养出48株真菌,念珠菌属37株,曲菌属6株,青霉菌属2株,顶孢霉属1株,未分类真菌2株。合并真菌感染的患者89%肿瘤分期为Ⅳ期,92%的患者曾使用多种广谱抗生素,出现中性粒细胞减少的患者比例为19%。不同部位真菌感染临床表现无特异性。37例中23例死亡,9例有效,1例手术后缓解,4例无法判断疗效。结论实体肿瘤患者侵袭性真菌感染发病率逐年增加;感染的菌种以念珠菌为主,约占80%,白色与非白色念珠菌几乎各占一半,曲菌居第2位,约占12·5%;实体肿瘤合并真菌感染的病死率高达62%。更多还原

【Abstract】 Objective To investigate the characteristics,manifestation,therapy and prognosis of invasive fungal infection in patients with solid tumor.Methods 37 solid tumor patients with invasive fungal infection,who were admitted in the PUMC hospital from Jan.1995 to Aug 2005,were studied retrospectively.Results There were 34 cases with lung fungal infection,1 case with biliary tract infection,4 cases with urinary infection and 3 cases with fungemia.48 fungal species were separated from all 37 patients,including 37 Candida species,6 Eurotium species,2 Penicillium speice,1 crem onium and 2 unclassified fungus species.89% patients had got metastatic cancer.92% patients used broad-spectrum antibiotic before.19% patients developed neutropenia.Among the 37 patients who received treatment,23 patients died,9 patients got response.Conclusion The incidence of fungal infection in solid tumor patients is increasing these years.The most-common pathopoiesis species were Candida(80%),Eurotium (12.5%).The mortalily of fungal infection in patients with solid tumor is very high (62%).更多还原