中文摘要：

目的提高对血液系统恶性疾病并发真菌性食管炎的认识。方法回顾性分析2012年1月至2015年11月河南省肿瘤医院血液科收治的279例行胃镜检查的恶性血液病患者临床资料，观察恶性血液病并发真菌性食管炎的临床特征及转归。结果279例患者中真菌性食管炎13例（4．66％），刷片镜检5例可见真菌孢子，3例可见真菌孢子及菌丝，5例仅见真菌菌丝。12例致病菌为白色念珠菌，1例为隐球菌。13例患者中弥漫大B细胞淋巴瘤8例，外周T细胞淋巴瘤1例，急性淋巴细胞白血病2例，多发性骨髓瘤1例；6例患者伴消化道症状（咽部异物感、恶心、纳差3例，胸骨后疼痛或烧灼感2例，吞咽困难伴疼痛1例），7例患者无明显症状体征。6例患者予氟康唑注射液400mg／d治疗14d，均有效；7例患者予制霉菌素片（100万u，每天3次）治疗14d，6例有效，1例持续不缓解，调整为氟康唑注射液400mg／d治疗7d后症状消失。治疗相关不良反应为一过性转氨酶升高及轻度消化道不良反应。结论恶性血液病并发真菌性食管炎并非少见，以淋巴系统疾病患者居多，致病菌主要为白色念珠菌；其临床症状不典型，约半数以上患者无明显临床表现；氟康唑及制霉菌素单药治疗安全有效。

英文摘要：

Objective To improve the clinical understanding of fungal esophagitis in patients with hematologic malignancies. Method The clinical data of a cohort of 279 patients with hematologic malignancies who underwent gastroscopy between 2012 and 2015 in the Endoscopy Center of Henan Tumor Hospital were retrospectively analyzed. To investigate the clinical characteristics and prognosis of fungal esophagitis in patients with heratologic malignancies. Results 13 of the 279 patients were diagnosed as fungal esophagitis （4.66%）. C. albicans was prevalent （12/13）, and only 1 case was cryptococcus. All of the 13 patients had lymphatic systemic diseases （8 cases with diffuse large B cell lymphoma, 1 with peripheral T-cell lymphoma, 2 with acute lymphoblastic leukemia, and 1 with multiple myeloma）. 6 patients had gastrointestinal symptoms （3 cases with nausea and anorexia as well as the sentation of having a foreign body in pharyngeal, 2 cases with pain or a burning sensation behind the sternum, and 1 case having difficulty or pain when swallowing）, while 7 patients had no obvious manifestations. 6 patients accepted fluconazole 400 mg/d for 2 weeks and achieved satisfactory results; Meanwhile 7 cases were given nystatin 1 million uint 3 times a day for 2 weeks, of which 6 cases responded well, and 1 case was not relieved until he was given fluconazole 400 mg/d for 1 week. Treatment- associated adverse events included mildly elevated aminotransferase （1 case） and mild gastrointestinal adverse reaction （ 1 case）. Conclusion The fungal esophagitis in patients with hematologic malignancies was not rare. Most of those patients had lymphatic systemic diseases and the main pathogen was candida albicans. The clinical manifestations of fimgal esophagitis were quite atypical and about more than half of those patients had no gastrointestinal symptoms. Either fluconazole or nystatin was safe and effective treatment with slight adverse reactions.