CAJ | 학술논문

目的：探讨两性霉素B脂质体在血液病患者侵袭性真菌感染的应用时机、疗效及如何减少不良反应。方法：回顾我院2例应用两性霉素B脂质体成功治疗血液病晚期患者侵袭性真菌感染的治疗过程。结果：1例为老年白血病患者，化疗后粒细胞缺乏期应用三唑类药物预防真菌感染失败，出现真菌败血症，改用两性霉素B抢先治疗后获得痊愈；另1例为原发性骨髓纤维化晚期患者，长期粒细胞缺乏导致颅内侵袭性真菌感染，应用三唑类药物治疗无效，及时更换两性霉素B脂质体后取得良好疗效。结论：两性霉素脂质体B具有很好的组织渗透性，治疗侵袭性真菌感染患者能降低病死率，能透过血脑屏障有效治疗颅内侵袭性真菌感染；脂质体剂型能有效降低两性霉素B的毒副作用。
목적：탐토량성매소B지질체재혈액병환자침습성진균감염적응용시궤、료효급여하감소불량반응。방법：회고아원2례응용량성매소B지질체성공치료혈액병만기환자침습성진균감염적치료과정。결과：1례위노년백혈병환자，화료후립세포결핍기응용삼서류약물예방진균감염실패，출현진균패혈증，개용량성매소B창선치료후획득전유；령1례위원발성골수섬유화만기환자，장기립세포결핍도치로내침습성진균감염，응용삼서류약물치료무효，급시경환량성매소B지질체후취득량호료효。결론：량성매소지질체B구유흔호적조직삼투성，치료침습성진균감염환자능강저병사솔，능투과혈뇌병장유효치료로내침습성진균감염；지질체제형능유효강저량성매소B적독부작용。
To investigate the indications, efifcacy and toxicity of liposomal amphotericin B in the treatment of invasive fungal infection in patients with hematological diseases. Methods:Two hematological patients with invasive fungal infection were successfully treated and their cases were retrospectively analyzed. Results:An elderly patient with leukemia failed to be treated with triazole antifungal agents as prophylaxis therapy after developed neutropenia following chemotherapy and he was diagnosed as fungal septicemia, then was treated with amphotericin B as a preemptive therapy and got a full recovery. Another patient with late stage primary myeloifbrosis suffered from intracranial invasive fungal infection due to long term of neutropenia. He was treated with amphotericin B and obtained a good therapeutic effect after failed to be treated with triazole antifungal agents. Conclusion: Liposomal amphotericin B has a good tissue penetrative ability, can reduce mortality when applied in the treatment of patients with invasive fungal infection, and can pass through the blood-brain barrier resulting in effective treatment of intracranial fungal infection. Its liposome formulation can effectively reduce the adverse effects related to amphotericin B.