伏立康唑治疗AIDS合并马尔尼菲青霉菌病的疗效与安全性
发布时间:2018-02-23 20:39
本文关键词: 马尔尼菲青霉菌病 伏立康唑 两性霉素B 艾滋病 出处:《中国艾滋病性病》2015年07期 论文类型:期刊论文
【摘要】:目的探讨单用伏立康唑(VO)及VO序贯两性霉素B(AMB)治疗艾滋病(AIDS)合并马尔尼菲青霉菌病(PSM)的疗效与安全性。方法前瞻性观察36例确诊AIDS合并PSM病人,单用VO及VO序贯AMB方案治疗后的疗效及不良反应。结果 36例病人中,男性28例,女性8例,平均年龄34.5岁。血和骨髓培养均发现马尔尼菲青霉菌(PM),抗真菌前83.3%存在肝功能受损,41.67%存在肾功能损害,50.0%发生严重贫血,19.4%外周血白细胞≤3×109/L,27.8%血小板≤50×109/L。初始治疗使用VO,治疗14天后复查血和骨髓培养PM情况:20例(55.6%)均转阴,16例(44.4%)仍阳性。复查PM转阴者继续使用VO,阳性者则改用AMB。36例病人使用VO 14天后临床症状好转,肝肾功能、血常规及血清钾改善(P0.05),未出现严重药物不良反应。16例序贯治疗病人使用AMB 14天后,血和骨髓培养均转阴,肝肾功能、血常规及血清钾无明显变化(P0.05),未发生明显不良反应。结论 VO治疗AIDS合并PSM多器官损害病人具有较好的疗效和安全性,并能改善病人一般情况,为进一步使用AMB根除PM创造机会。
[Abstract]:Objective to investigate the efficacy and safety of Volconazole (VOO) and VO sequential amphotericin (VO) in the treatment of AIDS with PSM. Results among 36 patients, 28 were male and 8 were female. The average age was 34. 5 years old. Blood and bone marrow culture showed that Penicillium marneffei was found to have liver function damage in 83.3% and liver function was impaired in 41.67% of patients with severe anemia. 19.4percent of peripheral blood leukocytes 鈮,
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