目的 探讨儿童急性白血病（acute leukemia, AL）化疗后合并慢性播散性念珠菌病（chronic disseminated candidiasis, CDC）的临床特征及预后。 方法 采用回顾性分析方法，以2015年1月—2023年12月在福建医科大学附属协和医院、福建医科大学附属漳州市医院及福建医科大学附属泉州第一医院的AL化疗后合并CDC（包括确诊、临床诊断与拟诊）的患儿作为研究对象，对其临床特征及预后进行分析。 结果 所有AL患儿化疗后合并CDC的发生率为1.92%（32/1 668）；急性淋巴细胞白血病患儿中，高危组CDC的发生率显著高于低危组（P=0.002）。所有患儿均表现为粒细胞缺乏期间抗生素治疗无效的发热，81%（26/32）累及肝脏。97%（31/32）的患儿C反应蛋白（C-reactive protein, CRP）明显升高（≥50 mg/L）。两性霉素B脂质体联合卡泊芬净或泊沙康唑治疗CDC的有效率为66%（19/29），高于卡泊芬净（9%，2/22）或两性霉素B脂质体（18%，2/11）单药治疗。总体治愈率为72%（23/32）。治疗失败组CRP≥50 mg/L和/或β-D-葡聚糖试验阳性持续时间超过2周、卡泊芬净治疗期间出现突破性感染的比例显著高于治疗成功组（均P<0.05）。 结论 儿童AL化疗后合并CDC可能与高强度化疗所致的持续粒细胞缺乏相关；以两性霉素B脂质体为基础的联合抗真菌方案有较高的治愈率，持续高CRP及β-D-葡聚糖试验阳性可能预后不良。

Objective To investigate the clinical characteristics and prognosis of chronic disseminated candidiasis (CDC) in children with acute leukemia (AL) following chemotherapy. Methods A retrospective analysis was conducted on children diagnosed with CDC (including confirmed, clinically diagnosed, and suspected cases) after AL chemotherapy from January 2015 to December 2023 at Fujian Medical University Union Hospital, Zhangzhou Municipal Hospital, and Quanzhou First Hospital Affiliated to Fujian Medical University. Clinical characteristics and prognosis were analyzed. Results The incidence of CDC in children with AL following chemotherapy was 1.92% (32/1 668). Among the children with acute lymphoblastic leukemia, the incidence of CDC in the high-risk group was significantly higher than in the low-risk group (P=0.002). All patients presented with fever unresponsive to antibiotics during the neutropenic period, with 81% (26/32) involving the liver. C-reactive protein (CRP) levels were significantly elevated (≥50 mg/L) in 97% (31/32) of the patients. The efficacy of combined therapy with liposomal amphotericin B and caspofungin or posaconazole for CDC was 66% (19/29), higher than with caspofungin (9%, 2/22) or liposomal amphotericin B (18%, 2/11) monotherapy. The overall cure rate was 72% (23/32). The proportion of patients with CRP ≥50 mg/L and/or a positive β-D-glucan test for more than 2 weeks and breakthrough infections during caspofungin treatment was significantly higher in the treatment failure group compared to the successful treatment group (P<0.05). Conclusions CDC in children with AL after chemotherapy may be associated with prolonged neutropenia due to intensive chemotherapy. Combination antifungal regimens based on liposomal amphotericin B have a higher cure rate, while persistently high CRP levels and positive β-D-glucan tests may indicate poor prognosis.