1例儿童耐锑剂黑热病治疗分析并文献复习  

Kala-Azar with Antimonial Resistance in Children:A Case Report and Literature Review

作　　者：刘锦 丁瑛雪[1] Liu Jin;Ding Yingxue(Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《儿科药学杂志》2023年第6期49-52,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨两性霉素B脂质体治疗儿童耐锑剂黑热病的有效性及安全性。方法:回顾性分析1例耐锑剂黑热病患儿给予两性霉素B脂质体治疗的病例资料,并进行相关文献复习。结果:患儿,女,1岁10个月,主因“间断发热伴脾大1年余”入院。生后10个月首次发病,表现为高热、贫血、肝脾肿大,抗感染效果欠佳,骨髓细胞学检查确诊黑热病,予多次锑剂治疗,出现复发及锑剂耐药,给予两性霉素B脂质体治疗,监测外周血及骨髓微生物宏基因组测序利什曼原虫转阴,获得临床及病原学治愈,目前随访8个月未见复发。结论:两性霉素B脂质体可治疗儿童耐锑剂黑热病,安全有效,不良反应少。Objective:To explore the effectiveness and safety of liposomal amphotericin B in the treatment of Kala-Azar with antimonial resistance in children.Methods:Clinical data of Kala-Azar with antimonial resistance in a child treated by liposomal amphotericin B were analyzed retrospectively,and the related literature were reviewed.Results:A 1-year-and-10-month-old girl with the main reason of admission for“intermittent fever accompanied by spleen enlargement for more than 1 year”.The first onset of the disease was 10 months after birth,manifested by high fever,anemia,hepatosplenomegaly,poor anti-infection effect,bone marrow cytology confirmed the diagnosis of Kala-Azar.The child was treated with antimonials for several times,yet recurrence and antimonial resistance occurred and then given amphotericin B liposome treatment.Peripheral blood and bone marrow microbial metagenomic sequencing results showed that leishmania was not found.The child was improved without recurrenc in eight-month follow-up.Conclusion:Liposomal amphotericin B can be used as an effective drug in the treatment of Kala-Azar with antimonial resistance in children.

关 键 词：两性霉素B脂质体 耐锑剂黑热病 儿童 

分 类 号：R725.1[医药卫生—儿科]