伏立康唑联合两性霉素B治疗侵袭性肺曲霉菌病1例分析  

Analysis of 1 case of invasive pulmonary aspergillosis treated by Voriconazole combined with Amphotericin B

作　　者：蒙晓[1] 陈文颖[2] 劳海燕[2] MENG Xiao;CHEN Wen-yin;LAO Hai-yan(Department of Pharmacy,the First Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510120,China;Department of Pharmacy (Training Base for Clinical Pharmacists),Guangdong Provincial People′s Hospital,Guangdong Province,Guangzhou 510080,China)

机构地区：[1]广州医科大学附属第一医院药学部,广东广州510120 [2]广东省人民医院药学部(临床药师培训基地),广东广州510080

出　　处：《中国当代医药》2019年第3期192-195,共4页China Modern Medicine

摘　　要：对1例伏立康唑联合两性霉素B治疗侵袭性肺曲霉菌病并治愈的病例进行分析,通过查阅文献,探讨抗真菌联合治疗在侵袭性曲霉菌病治疗中的安全性、有效性及合理性。现有研究结果显示,侵袭性曲霉菌病抗真菌联合治疗与单药治疗相比未明确能改善其预后,多烯类药物或三唑类药物联合棘白菌素类药物可能产生协同作用,多烯类药物联合三唑类药物可能产生拮抗作用。侵袭性曲霉菌病抗真菌联合治疗可能导致药物不良反应发生率增高,这与药物的剂量、疗程和特性有关;联合治疗方案由于缺乏充足的临床证据支持,故初始治疗不推荐使用,仅限补救治疗使用。Analysis a successful case of Voriconazole combined with Amphotericin B in the treatment of invasive pulmonary aspergillosis(IPA),and through consulting literature to study the safety,efficacy and rationality of combination therapyin the treatment of IPA.By consulting literature,the efficacy of combination therapy better than monotherapy are still uncertain.Polyene or triazoles combined with echinocandins maybe synergies,but polyene combined with triazoles maybe antagonisms.Combination therapy maybe increase adverse reaction which related to drug dose and course and properties.In the absence of sufficient clinical evidence,combination therapy is not recommended for initial treatment but as remedial treatment.

关 键 词：抗真菌治疗 曲霉菌病 联合治疗 伏立康唑 两性霉素B 肾毒性 

分 类 号：R563[医药卫生—呼吸系统]