恶性肿瘤患者侵袭性真菌感染的诊断标准与治疗原则-草案幻灯片1.pptVIP

恶性肿瘤患者侵袭性真菌感染的诊断标准与治疗原则 ;编者按 侵袭性真菌感染(invasive fungal infections, IFI)日益成为导致恶性血液病及恶性肿瘤患者死亡的重要病因之一。目前已知引起IFI最常见的致病真菌包括曲霉菌菌属和白色念珠菌，然而非白色念珠菌和其他微生物亦呈逐渐增多趋势。为了进一步规范IFI的诊断和治疗，中华内科杂志编辑委员会特约国内有关领域的著名专家，参照国外相关的标准，制定出适合国人的“血液病/恶性肿瘤患者侵袭性真菌感染的诊断标准与治疗原则(草案)”，现予以公布，供国内广大同道在临床实践中学习和借鉴。同时希望广大读者在实施过程中对本草案提出修改意见,以供再次修订时参考。 ;血液病/恶性肿瘤患者侵袭性真菌感染的诊断标准与治疗原则（草案） ;Defining Opportunistic Invasive Fungal Infections in Immunocompromised Patients with Cancer and Hematopoietic Stem Cell Transplants: An International Consensus Cooperative Group of the European Organization for Research and Treatment of Cancer and Mycoses Study Group of the National Institute of Allergy and Infectious Diseases During the past several decades, there has been a steady increase in the frequency of opportunistic invasive fungal infections (IFIs) in immunocompromised patients. However, there is substantial controversy concerning optimal diagnostic criteria for these IFIs. Therefore, members of the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group formed a consensus committee to develop standard definitions for IFIs for clinical research. On the basis of a review of literature and an international consensus, a set of research oriented definitions for the IFIs most often seen and studied in immunocompromised patients with cancer is proposed. Three levels of probability are proposed: “proven,” “probable,” and “possible.” The definitions are intended for use in the context of clinical and/or epidemiological research, not for clinical decision making.;讲座内容;一、真菌感染的基本知识和概念;啤酒酵母;对人类致病的真菌分浅部真菌和深部真菌 浅部真菌侵犯皮肤、指甲等，为慢性，具有顽固性，但对身体影响较小 深部真菌可侵犯全身内脏，严重的可引起死亡 类酵母菌—念珠菌属（白色念珠菌） 酵母菌类—隐球菌属 （新型隐球菌 ） 二相真菌—球孢子菌属、组织胞浆菌属、孢子丝菌属、芽生菌属、地丝菌属 霉菌类（丝状菌）—曲霉菌属、毛霉菌属、青霉菌属;致病性真菌对人体产生危害的形式 原发性真菌感染：主要是外源性感染 继发（条件）性真菌感染：主要是内源性感染（如白色念珠菌），亦有外源性感染（如曲霉菌），常发生于长期应用抗生素、激素、免疫抑制剂、化疗和放疗的患者 过敏性真菌病：系在各种过敏性或变态反性疾病中，由真菌性过敏原（如孢子抗原）引起过敏症 真菌毒素中毒