小剂量两性霉素B治疗艾滋病合并播散性马尔尼菲青霉菌病  

Low-dose amphotericin B therapy for disseminated penicilliosis marneffei in patients with acquired immunodefi- ciency syndrome

作　　者：梁欣[1] 姚钦江[1] 马卫国[1] 黎灿[1] 黄丽静[1] 

机构地区：[1]广西壮族自治区钦州市第一人民医院感染性疾病科,535000

出　　处：《国际流行病学传染病学杂志》2012年第2期98-101,共4页International Journal of Epidemiology and Infectious Disease

基　　金：广西医药卫生自筹经费计划课题（Z2009235）;钦州市科学研究与技术开发计划项目（20101904）

摘　　要：目的探讨小剂量两性霉素B治疗艾滋病合并播散性马尔尼菲青霉菌病的疗效和安全性。方法对使用小剂量两性霉素B治疗的104例艾滋病合并播散性马尔尼菲青霉菌病（DPsM）患者进行分析，于两性霉素B治疗结束时进行总体疗效评价及药物不良反应评估。结果小剂量两性霉素B治疗临床总显效率82．69％（86／104）。真菌清除率75．00％（63／84）。61例患者治疗期俐出现药物不良反应，对症处理后大部分患者能耐受。不良反应发生率依次为低钾血症39．42％（41／104）、肾功能损害26．92％（28／104）、寒颤25．00％（26／104）、肝功能损害22．10％（23／104）。结论小剂量两性霉素B治疗DPsM有效、可行，但须合理用药，密切监测肝肾功能、血钾水平。Objective To explore the efficacy and safety of low-dose araphotericin B therapy for disseminated penicilliosis mameffei（DPsM） in patients with AIDS. Methods One hundred and four patients of AIDS receiving low- dose amphoteriein B therapy for DPsM were analyzed. Efficacy and safety were evaluated at the end of low-dose amphotericin B therapy. Results At the end of therapy, clinical efficacy rate was 82.69%（86/104）, fungal ehmination rate was 75.00% （63/84）. Sixty-one patients developed amphotericin B related adverse drug reactions and most of them were well tolerated. Common adverse drug reactions were as follows： hypokalemia accounted for 39.42% （41/104）, renal dysfunction accounted for 26.92 % （28/104）, chills accounted for 25.00% （26/104）and liver function damage accounted for 22.10% （23/104）, respectively. Conclusions Low-dose amphotericin B therapy for DPsM in patients with AIDS is effective and feasible, but hepatic and renal functions and electrolyte balance should be monitored.

关 键 词：获得性免疫缺陷综合征 青霉菌属 真菌病 两性霉素B 治疗 

分 类 号：R512.91[医药卫生—内科学]