两性霉素B治疗恶性血液肿瘤合并真菌感染40例临床分析  

Amphotericin B for treatment of fungal infections in 40 patients with malignant hematologic diseases

作　　者：杨钟波[1] 江滨[1] 任汉云[1] 丘镜滢[1] 王贺[2] 王德炳[1] 

机构地区：[1]北京大学人民医院血液病研究所,100044 [2]北京大学人民医院细菌室,100044

出　　处：《中华内科杂志》2001年第11期757-759,共3页Chinese Journal of Internal Medicine

摘　　要：目的　观察静脉用两性霉素B对血液系统恶性肿瘤病人真菌感染的临床疗效及安全性。方法　 4 0例恶性血液病患者 (男 2 7例 ,女 13例 ,中数年龄 35 5岁 ) ,出现真菌感染者使用两性霉素B ,剂量为 5～ 5 0mg/d ,用药天数为 5～ 85d ,中数 2 1d。结果　两性霉素B临床总有效率为5 2 5 % ,真菌清除率为 5 6 2 % ,不良反应发生率中寒战、发热 2 5 % ,低血钾 12 5 % ,肝肾功能损害各为15 0 %。结论　两性霉素B因其抗菌谱较广 ,且疗效好 ,在治疗深部真菌感染中为高效药物 ,但因其不良反应较大 ,限制其使用。我们的研究表明 :只要合理用药 ,定期监测肝肾功能 。Objective To observe the therapeutic effect and side effects of amphotericin B for fungal infections in patients with malignant hematologic diseases. Methods 40 patients (male 27, female 13; average age 35.5 years) with malignant hematologic diseases were given amphotericin B, 5～50 mg/d per day for 5～85 days (average time 21 days).Results The clinical efficacy rate of amphotericin B was 52.5%, and the fungal elimination rate was 56.2%. Among the side effects, rigor and fever were present in 2.5% of the patients. Hypokalaemia was found in 12.5%, hepatotoxicity in 15 0% and nephrotoxicity in 15 0%.Conclusion As amphotericin B has a broad anti fungal spectrum and relatively good efficacy, it is still a high efficiency drug in treatment of systematical fungal infections. However ,the use of this drug is limited because of its many side effects. Our study indicates that if it is used properly and hepatic and renal function tests are carried out regularly, amphotericin B is a relatively safe and effective drug.

关 键 词：两性霉素B 恶性血液肿瘤 真菌病 并发症 药物治疗 

分 类 号：R550.5[医药卫生—血液循环系统疾病]