粉防己碱对酮康唑抗近平滑念珠菌复合体的体外增效活性研究  

In vitro synergistic effect of tetrandrine on ketoconazole against Candida parapsilosis complex

作　　者：赵亚婧 李水秀[1] 蒋玲[1] 宋延君[1] 郭慧[1] 刘维达[2] 沈永年[2] 朱坤举[1] 张宏[1] 

机构地区：[1]暨南大学附属第一医院真菌病研究所,广州510632 [2]中国医学科学院北京协和医学院皮肤病研究所真菌科

出　　处：《中华皮肤科杂志》2017年第6期417-420,共4页Chinese Journal of Dermatology

基　　金：国家自然科学基金（81171542、81471995）

摘　　要：目的探讨粉防己碱在体外对酮康唑抗近平滑念珠菌复合体有无增效作用。方法参照美国临床和实验室标准协会（CLSI）推荐的M27-A3方案，采用棋盘式微量稀释法测定酮康唑单独及联合粉防己碱抗21株近平滑念珠菌复合体临床株抗真菌活性，结合部分抑制浓度指数（FICI）对结果进行评价；以甲基四氮盐（xTT）法分别测定不同时间点药物作用的效果，绘制时间杀菌曲线，动态观察药物体外抗近平滑念珠菌复合体活性。结果粉防己碱与酮康唑单独作用于21株近平滑念珠菌复合体菌株的最低抑菌浓度分别是32—64mg／L和0．03125～2mg／L，两药联合时最低抑菌浓度分别降至2．8mg／L和0．008。0．25mg／L，FICI值为0．09～0．5；时间杀菌曲线表明，与酮康唑单用组和粉防己碱单用组相比，酮康唑联合粉防己碱组真菌生长延迟明显。结论粉防己碱在体外对酮康唑抗近平滑念珠菌复合体有明显的增效作用。Objective To evaluate the in vitro synergistic effect of tetrandrine on ketoconazole against Candida parapsilosis complex. Methods According to the Clinical and Laboratory Standards Institute （CLSI） M27-A3 guidelines, the microdilution checkerboard method was used to evaluate in vitro antifungal activities of ketoconazole alone and in combination with tetrandrine against 21 clinical isolates of Candida parapsilosis complex based on the fractional inhibitory concentration index （FICI）. Antifungal effects of the above drugs at different time points were evaluated by the XTT assay, and then time-killing curves were drawn and assessed to investigate the in vitro dynamic antifungal activity. Results The minimum inhibitory concentrations （MICs） of tetrandrine and ketoconazole alone against 21 clinical isolates of Candida parapsilosis complex were 32- 64 mg/L and 0.031 25- 2 mg/L, respectively. When ketoconazole was combined with tetrandrine, MICs of tetrandrine and ketoconazole were reduced to 2 - 8 mg/L and 0.008 - 0.25 mg/L respectively, and the FICI ranged from 0.09 to 0.5. The time-killing curves revealed that the fungal growth was delayed obviously in the combination group compared with the ketoconazole alone group and tetrandrine alone group. Conclusion Tetrandrine has obvious synergistic effects on ketoconazole against Candida parapsilosis complex in vitro.

关 键 词：念珠菌属 酮康唑 粉防己碱 药物协同作用 近平滑念珠菌复合体 

分 类 号：R519.3[医药卫生—内科学]