摘要
目的探讨小剂量国产两性霉素B对医院侵袭性真菌感染(IFI)的疗效与安全性。方法 78例IFI患者给予两性霉素B治疗,初始3d的剂量为1、3、5mg,加入5%葡萄糖溶液50ml,保持速度为5ml/h,从第4天开始每日增加5mg,直至25mg,以后维持该剂量;疗程1～5个月,总用药量1～1.5g。结果 78株真菌中白色假丝酵母菌占61.5%,热带假丝酵母菌占16.7%,光滑假丝酵母菌占7.7%,近平滑假丝酵母菌占5.1%,克柔假丝酵母菌占3.9%;治疗结束1周后进行疗效评价,痊愈10例,显效51例,进步8例,无效9例,其中1例死亡,总有效率为78.2%;真菌清除66例,未清除12例,清除率为84.6%;有33例发生不良反应,不良反应发生率为42.3%;33例患者共发生61次不良反应,其中发生1种不良反应14例,2种12例,3种5例,4种2例;低钾血症、肾功能损害、肝功能损害、静脉炎和寒颤发热的发生率分别为33.3%、17.9%、12.8%、6.4%和7.7%。结论小剂量国产两性霉素B对IFI临床疗效好,对真菌清除率高,在应用的同时应监测低钾血症和肝肾功能;小剂应用国产两性霉素B在一定程度上还是安全的。
OBJECTIVE To discuss the efficacy and safety of domestic low-dose amphotericin B for invasive fungal infection in the hospital（invasive fungal infection,IFI）. METHODS IFI 78 patients were given amphotericin B treatment,the initial dose of the 3 d 1,3,5 mg,5% glucose solution,50 ml,maintaining a speed of 5ml/h,an increase from 4 d to start his daily 5 mg,until 25 mg,then maintained the dose after wards.Course of treatment is 1 to 5 months,the total dosage is 1~1.5 g. RESULTS Of totally 78 strains of fungi,Candida albicans accounted for 61.5%,C.tropicalis accounted for 16.7%,smooth C.albicans 7.7%,C.parapsilosis accounted for 5.1%,C.krusei 3.9%,Fungi 5.1%,1 week after the end of treatment efficacy evaluation,10 cases recovered,51 cases markedly,progress in 8 cases,9 cases invalid,1 case death,the total effective rate was 78.2%,66 cases of fungal clearance,did not clear the 12 cases,clearance rate was 84.6%.33 cases of adverse reactions,adverse reaction rate was 42.3%.A total of 33 patients,61 adverse events occurred,which 1 species occurring adverse reactions in 14 cases,12 cases 2,3 in 5 cases,2 cases of 4.Hypokalemia,renal dysfunction,liver dysfunction,phlebitis,and the incidence of chills,fever and were 33.3%,17.9%,12.8%,6.4% and 7.7%,respectively. CONCLUSION China-made low-dose amphotericin B has good clinical efficacy IFI,fungal clearance rate on the same time,hypokalemia and renal function monitoring,to a certain extent,is still safe.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第23期5049-5051,共3页
Chinese Journal of Nosocomiology
