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原发性血小板减少性紫癜合并侵袭性真菌感染2例报告附文献复习
引用本文:叶丽萍,刘丽辉,刘莉.原发性血小板减少性紫癜合并侵袭性真菌感染2例报告附文献复习[J].中国真菌学杂志,2006,1(3):146-148.
作者姓名:叶丽萍  刘丽辉  刘莉
作者单位:解放军总医院第二附属医院血液科,北京,100091
基金项目:感谢解放军307医院胡亮钉主任的指导
摘    要:目的 报道2例难治性原发性血小板减少性紫癜(ITP)患者用大剂量激素和(或)免疫抑制剂后发生侵袭性真菌感染(IFI),其治疗经过及相关文献复习。方法 2例难治性ITP患者用大剂量激素和(或)免疫抑制剂后发生IFI,用大扶康、两性霉素B,降颅压,辅助呼吸等治疗。结果 例1发生隐球菌脑膜脑炎、例2出现肺曲酶菌感染,均经抗真菌治疗无效死亡。结论 长期应用激素及免疫抑制剂是难治性ITP患者发生IFI的危险因素,治疗困难,确诊后用药应足量、足疗程。

关 键 词:难治性ITP  真菌感染  治疗
文章编号:1673-3827(2006)03-0146-03
收稿时间:2006-01-11
修稿时间:2006年1月11日

Refractory idiopathic thrombocytopenic purpura complicated with invasive fungal infection: report of 2 cases and review of literature
YE Li-ping,LIU Li-hui,LIU Li.Refractory idiopathic thrombocytopenic purpura complicated with invasive fungal infection: report of 2 cases and review of literature[J].Chinese JOurnal of Mycology,2006,1(3):146-148.
Authors:YE Li-ping  LIU Li-hui  LIU Li
Abstract:Objective To report 2 cases of refractory idiopathic thrombocytopenic purpura (RITP) complicated with invasive fungal infection(IFI) and review of literature.Methods Two patients with RITP who had received immuno-suppressive agents and/or large-dose corticosteroids were diagnosed as complicated with IFI. In addition to lowering intracranial pressure by draining CSF through lumbar puncture and artificial respiration by respirator,fluconazole and Amphotericin B were used as treatment.Results After treatment, the number of platelet of 2 cases of patients increased. One case got cryptococcal meningitis, the other case got pulmonary aspergillosis .Both died eventually after the antifungal therapy.Conclusion Risk factors of IFI included long-term use of corticosteroids and/or immuno-suppressive agents for patients with RITP.It is difficult for the successful antifungal therapy.When diagnosis was confirmed,antifungal therapy should be promptly,sufficient and long-term.
Keywords:refractory idiopathic thrombocytopenic purpura  fungal infection  therapy
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