泊沙康唑防治侵袭性肺部真菌感染的机制与临床研究进展

发布时间：2018-02-22 16:51

本文关键词： 泊沙康唑侵袭性肺部真菌感染防治　出处：《中国药房》2017年10期 　论文类型：期刊论文

【摘要】：目的:为泊沙康唑防治侵袭性肺部真菌感染(IPFI)的机制研究与临床应用提供参考。方法:以"Posaconazole""Invasive pulmonary fungal infection""泊沙康唑""侵袭性肺部真菌感染"等为关键词,组合查询2001年1月-2015年10月在PubMed、Springer Link、Wiley Online Library、中国知网、万方、维普等数据库中的相关文献,对泊沙康唑的药品基本信息、药动学/药效学特征、药理作用及其作用机制和临床研究进行综述。结果:共检索到相关文献3 478篇,其中有效文献51篇。泊沙康唑属于三唑类抗真菌药,其分子结构的特点是在母环基础上延伸出一条侧链,具有呋喃环,同时以氯代替了苯环上的氟,可抑制真菌细胞膜上合成麦角固醇的关键酶羊毛甾醇14α-去甲基化酶,从而发挥抗真菌作用;其具有耐药性低、生物利用度高、肺内浓度高等特点。泊沙康唑在小鼠肺内的药物浓度高,药-时曲线下面积与最低抑菌浓度的比值可达440.91,对感染肺曲霉菌、毛霉菌的小鼠具有抗真菌效果。泊沙康唑对IPFI有一定效果,甚至可作为难治性IPFI的挽救治疗用药,但仅限于临床观察研究和个案报道,尚需更多高质量的临床随机对照研究进一步评估其防治IPFI的价值。
[Abstract]:Objective: to study the mechanism and clinical application of posaconazole in the prevention and treatment of invasive pulmonary fungal infection. Methods: "Posaconazole", "Invasive pulmonary fungal infection", "posaconazole", "invasive pulmonary fungal infection", etc. A combined query was made on the relevant documents in the database of PubMedus Springer Linkler Online Library, China Zhiwang, Wanfang and Weip from January 2001 to October 2015. The pharmacokinetic / pharmacodynamic characteristics of Posaconazole were analyzed, and the pharmacokinetic and pharmacodynamic characteristics of Posarconazole were analyzed. Results: a total of 3,478 related literatures were retrieved, of which 51 were effective. Posaconazole was a triazole antifungal drug. Its molecular structure is characterized by the extension of a side chain on the base of the mother ring, the existence of furan ring, and the substitution of chlorine for fluorine on the benzene ring, which can inhibit the synthesis of ergosterol on the cell membrane of fungi by the key enzyme, wool sterol 14 伪 -demethylase. It has the characteristics of low drug resistance, high bioavailability and high intrapulmonary concentration. The ratio of the area under the drug-time curve to the minimum inhibitory concentration was 440.91, which had antifungal effect on mice infected with Aspergillus pneumoniae and Mucor. Posaconazole had a certain effect on IPFI, and could even be used as a salvage therapy for refractory IPFI. But it is limited to clinical observation and case report. More high quality randomized controlled trials are needed to evaluate the value of IPFI prevention and treatment.
【作者单位】：重庆医科大学附属第一医院呼吸内科;
【分类号】：R519

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