小剂量两性霉素B脂质体对恶性血液病患者肾功能及血钾的影响  

Effect of low dosage of liposomal amphotericin B on renal function and serum potassium in patients with malignant hematological disease

作　　者：李景贺[1,2] 李彦卿[1] 姚子龙[1] 姚盛[1] 杨岚[1] 刘静[1] 石亚男[1] 刘占祥[1] 卢柠[1] 李文君[1] 靖彧[1] 

机构地区：[1]解放军总医院血液科,北京100853 [2]吉林大学第二医院肿瘤血液科,吉林长春130041

出　　处：《解放军医学院学报》2015年第12期1192-1194,共3页Academic Journal of Chinese PLA Medical School

基　　金：海南省医药卫生科研项目(琼卫2013资助-096);海南省产学研一体化专项资金(CXY20140013)

摘　　要：目的探讨小剂量两性霉素B脂质体对恶性血液病患者的安全性。方法回顾性分析解放军总医院血液科2013年6月-2015年4月收治的46例恶性血液病患者,其中男性33例,女性13例,平均年龄为39(17~77)岁。观察患者小剂量两性霉素B脂质体治疗前、后的肌酐(Cre)、尿素氮(BUN)及血钾(K^+)水平,分析治疗后肌酐、尿素氮、血钾的变化情况。结果小剂量两性霉素B脂质体治疗后肌酐较治疗前升高4.24μmol/L,血钾较治疗前降低0.05 mmol/L,但均无统计学差异(P>0.05);尿素氮较治疗前升高0.94 mmol/L(P<0.05)。结论小剂量两性霉素B脂质体的肾毒性发生率极低,对肌酐影响不明显,对尿素氮有一定影响,可使血钾降低,但差异无统计学意义。Objective To evaluate the potential toxicity of low dosage of liposomal amphotericin B on renal function and serum potassium in patients with malignant hematological disease. Methods A total of 46 patients with malignant hematological disease（33 male and 13 female with mean age of 39 years, range 17-77 years） from June 1, 2013 to April 30, 2015 in Chinese PLA General Hospital were enrolled in this study. The data of serum Cre, BUN, and potassium K＋ were collected before and after liposomal amphotericin B was given. The changes of serum Cre, BUN, and potassium K^＋ after treatment and the incidence of serum Cre, BUN, and potassium K＋ with change level more than 30% after treatment were analyzed. Results Compared with patients before treatment, the creatinine increased 4.24μmol/L and serum potassium decreased 0.05 mmol/L after treatment with low dosage of liposomal amphotericin B, but the difference were not statistically significant（P〉0.05）. While, urea nitrogen increased 0.94 mmol/L after treatment compared with patients before treatment with significant difference（P〈0.05）. Conclusion The incidence of toxicity to renal function in patients with low dosage of liposomal amphotericin B is quite low. There is no effect on serum creatinine, while it has a certain effect on serum urea nitrogen. And no significant difference is found in decreased potassium.

关 键 词：两性霉素B脂质体 肾功能 低钾血症 

分 类 号：R551[医药卫生—血液循环系统疾病] R453.2[医药卫生—内科学]