摘要
目的：评估两性霉素 B 联合伊曲康唑治疗恶性血液病合并肺部侵袭性真菌病的临床疗效及安全性。方法回顾性分析郑州大学第一附属医院2011年7月~2013年7月间收治的恶性血液病合并肺部侵袭性真菌病144例，其中接受两性霉素 B 联合伊曲康唑治疗者44例，单用两性霉素 B 者40例，单用伊曲康唑者60例，观察并比较其疗效和安全性。结果联合组、两性霉素 B 组、伊曲康唑组的总有效率分别为79%、55%和52%，联合组与两性霉素 B 组、伊曲康唑组比较差异均有统计学意义（P=0.023、0.004）。联合组、两性霉素 B 组的低钾血症发生率高于伊曲康唑组（P=0.021、0.004），余不良反应三组间无明显差异。结论两性霉素 B 联合伊曲康唑治疗恶性血液病合并肺部侵袭性真菌病的疗效优于两性霉素 B 或伊曲康唑单药治疗，不良反应无明显增加。
Objective To evaluate the efficacy and safety of amphotericin B combined with itraconazole in the treatment of pulmonary invasive fungal disease in patients with hematological malignancies. Methods A total of 144 cases of patients with hematological malignancies complicated by pulmonary invasive fungal disease from July 2011 to July 2013 in our hospital were retrospectively analyzed. 44 cases were treated with Amphotericin B combined with itraconazole, 40 cases were treated with Amphotericin B and 60 cases were treated with itraconzole. Results The total clinical response rate of cases treated with Amphotericin B combined with itraconazole, Amphotericin B and Itraconzole were 79%, 55%, and 52%, respectively. There were significant differences of the response rates between Amphotericin B combined with itraconazole and Amphotericin B, Itraconzole （P=0.023, 0.004, respectively）. The incidence of hypokalemia in cases received Amphotericin B combined with itraconazole and Amphotericin B alone were higher than those received Itraconzole alone （P=0.021, 0.004, respectively）. There were no significant differences of the incidence rates of other adverse events among three groups. Conclusion The response rate of Amphotericin B combined with itraconazole is higher than that of Amphotericin B or itraconazole in the treatment of pulmonary invasive fungal disease with no increasing toxicity.
出处
《中国继续医学教育》
2014年第7期147-151,共5页
China Continuing Medical Education
关键词
恶性血液病
肺部侵袭性真菌病
伊曲康唑
联合抗真菌治疗
两性霉素B
Hematological malignancies
Pulmonary invasive fungal disease
Amphotericin B
Itraconzole
Combination antifungal therapy
