毛霉病的治疗进展  

Treatments of mucormycosis

作　　者：张思平[1] 

机构地区：[1]安徽省立医院皮肤科,合肥230001

出　　处：《国际皮肤性病学杂志》2017年第1期21-24,共4页International Journal of Dermatology and Venereology

摘　　要：毛霉病是一种侵袭感染真菌病，主要发生于免疫功能受抑制的患者，致死率高。毛霉病的治疗方法很多，外科手术清创联合有效的抗真菌药物是主要的治疗策略。治疗毛霉病的抗真菌药物有多烯类、唑类、棘白霉素类以及抗真菌药物联合治疗，其中最有效的药物为多烯类，其次是唑类抗真菌，最主要的唑类药有泊沙康唑，另外，伏立康唑和新的唑类药艾沙康唑也可治疗毛霉病。棘白霉素单独治疗毛霉疗效不佳，与其他抗真菌联合应用有协同治疗作用。铁螯合剂和高压氧的疗效尚待研究。两性霉素B脂质体作为首选治疗，而泊沙康唑是很有前景的治疗毛霉药物。早期积极联合治疗有助于降低毛霉病的死亡率。Mucormycosis is an invasive fungal infection with high mortality, and mainly occurs in immunocompromised patients. Many treatments are available for mucormycosis, and surgical debridement in combination with antifungal agents is the main therapeutic strategy. Polyenes, azoies and echinocandins, alone or in combination, are used for the treatment of mucormycosis. The most effective antifungal agent is polyenes, followed by azoles which mainly include posaconazole. In addition, vorieonazole and new azoles such as isavuconazole are also applied in the treatment of mucormycosis. The efficacy of echinocandins alone is poor, but its combination with other antifungal agents shows good synergistic effects. Further studies are needed to evaluate the therapeutic effects of iron chelating agents and hyperbaric oxygen. Amphotericin B lipid usually serves as the preferred treatment, and posaconazole is regarded as a promising alternative. Early active and combined treatment is helpful in decreasing the mortality of mucormycosis.

关 键 词：毛霉菌病 毛霉菌属 治疗应用 外科手术 抗真菌药 药物疗法 联合 

分 类 号：R756[医药卫生—皮肤病学与性病学]