不同抗真菌方案对艾滋病合并马尔尼菲蓝状菌病疗效及安全性的对比研究  被引量:1

Comparative Study on the Efficacy and Safety of Different Antifungal Regimens in AIDS with Talaromycosis Marneffei

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作  者:唐贵 黄小红 陈涛[1] 蒋忠胜[1] 胡家光[1] 覃锦玉 TANG Gui;HUANG Xiaohong;CHEN Tao;JIANG Zhongsheng;HU Jiaguang;QIN Jinyu(Department of Infectious Diseases,Ward II,Liuzhou People's Hospital,Liuzhou,Guangxi Zhuang Autonomous Region,545000 China)

机构地区:[1]柳州市人民医院感染性疾病科二病区,广西柳州545000

出  处:《系统医学》2023年第17期1-4,共4页Systems Medicine

基  金:广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190332);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180286);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200297);柳州市科学技术局自筹经费科研课题(2021CBC0107)。

摘  要:目的探究两性霉素B和伏立康唑治疗艾滋病(acquired immune deficiency syndrome,AIDS)合并马尔尼菲蓝状菌病(talaromycosis marneffei,TSM)患者的临床疗效。方法选取2016年1月—2021年12月于柳州市人民医院确诊为AIDS合并TSM的患者60例为研究对象。按随机数表法分为两性霉素B组(30例)和伏立康唑组(30例),分别给予两性霉素B、伏立康唑治疗,观察两组患者的临床疗效、血常规及肝肾功能水平。结果两性霉素B治疗AIDS合并TSM患者的总有效率与伏立康唑组相近,且两组患者治疗前后血常规及肝功能指标比较,差异无统计学意义(P>0.05),但治疗后伏立康唑组患者肾功能指标肌酐(58.60±4.21)μmol/L、尿素氮(4.24±0.59)mmol/L水平低于两性霉素B组患者,差异有统计学意义(t=4.266、2.151,P<0.05)。结论两性霉素B和伏立康唑均可有效治疗AIDS合并TSM患者,其治疗有效性和肝功能损害程度相近。但伏立康唑对患者肾功能损害更小于两性霉素B。临床治疗时可根据患者实际情况选择适宜的抗真菌方案,以延长患者生存时间。Objective To explore the clinical efficacy of amphotericin B and voriconazole in the treatment of acquired immune deficiency syndrome(AIDS)with talaromycosis marneffei(TSM).Methods 60 patients diagnosed with AIDS combined with TSM in Liuzhou People's Hospital from January 2016 to December 2021 were selected as the study ob-jects.They were divided into amphotericin B group(30 cases)and voriconazole group(30 cases)according to random number table method,and were treated with amphotericin B and voriconazole respectively.The clinical efficacy,blood routine and liver and kidney function of the two groups were observed.Results The total effective rate of amphotericin B in AIDS patients with TSM was similar to that in voriconazole group,and there was no statistically significant differ-ence in blood routine and liver function indexes between the two groups before and after treatment(P>0.05).However,the renal function index Scr(58.60±4.21)μmol/L and BUN(4.24±0.59)mmol/L in voriconazole group were lower than those in amphotericin B group after treatment,and the difference was statistically significant(t=4.266,2.151,P<0.05).Conclusion Both amphotericin B and voriconazole can effectively treat AIDS patients with TSM,and their therapeutic effectiveness is similar to the degree of liver function damage.However,voriconazole had less damage to renal func-tion than amphotericin B.In clinical treatment,appropriate antifungal regimens can be selected according to the ac-tual situation of patients to prolong the survival time of patients.

关 键 词:两性霉素B 伏立康唑 艾滋病 马尔尼菲蓝状菌病 

分 类 号:R512.97[医药卫生—内科学]

 

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