中国继续医学教育
中國繼續醫學教育
중국계속의학교육
CHINA CONTINUING MEDICAL EDUCATION
2014年
7期
147-151
,共5页
刘延方%王树娟%王冲%王伟琼%郝倩倩%孙慧%马杰
劉延方%王樹娟%王遲%王偉瓊%郝倩倩%孫慧%馬傑
류연방%왕수연%왕충%왕위경%학천천%손혜%마걸
恶性血液病%肺部侵袭性真菌病%两性霉素 B%伊曲康唑%联合抗真菌治疗
噁性血液病%肺部侵襲性真菌病%兩性黴素 B%伊麯康唑%聯閤抗真菌治療
악성혈액병%폐부침습성진균병%량성매소 B%이곡강서%연합항진균치료
Hematological malignancies%Pulmonary invasive fungal disease%Amphotericin B%Itraconzole%Combination antifungal therapy
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。
目的：評估兩性黴素 B 聯閤伊麯康唑治療噁性血液病閤併肺部侵襲性真菌病的臨床療效及安全性。方法迴顧性分析鄭州大學第一附屬醫院2011年7月~2013年7月間收治的噁性血液病閤併肺部侵襲性真菌病144例，其中接受兩性黴素 B 聯閤伊麯康唑治療者44例，單用兩性黴素 B 者40例，單用伊麯康唑者60例，觀察併比較其療效和安全性。結果聯閤組、兩性黴素 B 組、伊麯康唑組的總有效率分彆為79%、55%和52%，聯閤組與兩性黴素 B 組、伊麯康唑組比較差異均有統計學意義（P=0.023、0.004）。聯閤組、兩性黴素 B 組的低鉀血癥髮生率高于伊麯康唑組（P=0.021、0.004），餘不良反應三組間無明顯差異。結論兩性黴素 B 聯閤伊麯康唑治療噁性血液病閤併肺部侵襲性真菌病的療效優于兩性黴素 B 或伊麯康唑單藥治療，不良反應無明顯增加。
목적：평고량성매소 B 연합이곡강서치료악성혈액병합병폐부침습성진균병적림상료효급안전성。방법회고성분석정주대학제일부속의원2011년7월~2013년7월간수치적악성혈액병합병폐부침습성진균병144례，기중접수량성매소 B 연합이곡강서치료자44례，단용량성매소 B 자40례，단용이곡강서자60례，관찰병비교기료효화안전성。결과연합조、량성매소 B 조、이곡강서조적총유효솔분별위79%、55%화52%，연합조여량성매소 B 조、이곡강서조비교차이균유통계학의의（P=0.023、0.004）。연합조、량성매소 B 조적저갑혈증발생솔고우이곡강서조（P=0.021、0.004），여불량반응삼조간무명현차이。결론량성매소 B 연합이곡강서치료악성혈액병합병폐부침습성진균병적료효우우량성매소 B 혹이곡강서단약치료，불량반응무명현증가。
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.
