中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
9期
919-921
,共3页
牛晓敏%许晓军%何慧清%宋奎%李卫华%黎伟超
牛曉敏%許曉軍%何慧清%宋奎%李衛華%黎偉超
우효민%허효군%하혜청%송규%리위화%려위초
两性霉素B%血液病%侵袭性真菌感染
兩性黴素B%血液病%侵襲性真菌感染
량성매소B%혈액병%침습성진균감염
Amphotericin B%Hematologic malignancies%Invasive fungal infection
目的 探讨小剂量两性霉素B治疗恶性血液病侵袭性真菌感染的有效性及安全性.方法 我院2008年1月至2012年6月接受治疗的恶性血液病合并侵袭性真菌感染患者98例,应用计算机随机分为对照组和实验组,对照组47例,两性霉素B维持剂量为50 ~ 60 mg/d;实验组51例,两性霉素B维持剂量为25~ 30 mg/d.比较两组的疗效和不良反应发生率.结果 两性霉素B中位累计剂量对照组为725(175,1595) mg,实验组为735(225,1485) mg,差异无统计学意义(P =0.834);治疗中位时间对照组为19(8,34)d,实验组为29(11,58)d,差异有统计学意义(P=0.000).治疗14 d对照组与实验组可评估疗效者分别为37例和48例,两组总有效率、无进展率、热退率差异均无统计学意义(P均>0.05).因不良反应终止治疗者对照组14例(29.8%),实验组6例(11.8%),差异有统计学意义(P=0.027);对照组肝肾功能损害发生率高于实验组[27.7% (13/47)与11.8%(6/51),P=0.047].结论 两性霉素B维持剂量25 ~ 30 mg/d临床疗效不低于维持剂量50~60 mg/d,不良反应少,临床可操作性强,具有可实践性.
目的 探討小劑量兩性黴素B治療噁性血液病侵襲性真菌感染的有效性及安全性.方法 我院2008年1月至2012年6月接受治療的噁性血液病閤併侵襲性真菌感染患者98例,應用計算機隨機分為對照組和實驗組,對照組47例,兩性黴素B維持劑量為50 ~ 60 mg/d;實驗組51例,兩性黴素B維持劑量為25~ 30 mg/d.比較兩組的療效和不良反應髮生率.結果 兩性黴素B中位纍計劑量對照組為725(175,1595) mg,實驗組為735(225,1485) mg,差異無統計學意義(P =0.834);治療中位時間對照組為19(8,34)d,實驗組為29(11,58)d,差異有統計學意義(P=0.000).治療14 d對照組與實驗組可評估療效者分彆為37例和48例,兩組總有效率、無進展率、熱退率差異均無統計學意義(P均>0.05).因不良反應終止治療者對照組14例(29.8%),實驗組6例(11.8%),差異有統計學意義(P=0.027);對照組肝腎功能損害髮生率高于實驗組[27.7% (13/47)與11.8%(6/51),P=0.047].結論 兩性黴素B維持劑量25 ~ 30 mg/d臨床療效不低于維持劑量50~60 mg/d,不良反應少,臨床可操作性彊,具有可實踐性.
목적 탐토소제량량성매소B치료악성혈액병침습성진균감염적유효성급안전성.방법 아원2008년1월지2012년6월접수치료적악성혈액병합병침습성진균감염환자98례,응용계산궤수궤분위대조조화실험조,대조조47례,량성매소B유지제량위50 ~ 60 mg/d;실험조51례,량성매소B유지제량위25~ 30 mg/d.비교량조적료효화불량반응발생솔.결과 량성매소B중위루계제량대조조위725(175,1595) mg,실험조위735(225,1485) mg,차이무통계학의의(P =0.834);치료중위시간대조조위19(8,34)d,실험조위29(11,58)d,차이유통계학의의(P=0.000).치료14 d대조조여실험조가평고료효자분별위37례화48례,량조총유효솔、무진전솔、열퇴솔차이균무통계학의의(P균>0.05).인불량반응종지치료자대조조14례(29.8%),실험조6례(11.8%),차이유통계학의의(P=0.027);대조조간신공능손해발생솔고우실험조[27.7% (13/47)여11.8%(6/51),P=0.047].결론 량성매소B유지제량25 ~ 30 mg/d림상료효불저우유지제량50~60 mg/d,불량반응소,림상가조작성강,구유가실천성.
Objective To investigate the efficacy and safety of low dose amphotericin B for treating invasive fungal infection (IFI) in hematologic malignancies.Methods Ninety-eight patients with hematologic diseases who visited our hospital from January 2008 to June 2012 were randomly divided into the control group (n =47) and the treatment group(n =51).Patients in the control group were treated with amphotericin B,50-60 mg per day and patients in treatment group were given amphotericin B,25-30 mg per day.Clinical efficacy and side effects were compared between the two groups.Results There was no significant difference on the median cumulative dose between the control group and the treatment group(725 (175,1595) mg vs 735 (225,1485) mg,P =0.834).But there was significant difference on median treatment days between the control group and the treatment group(19(8,34) d vs 29(11,58) d,P =0.000).After treatment for 14 days,the patients who can be evaluated for efficacy were 37 and 48 cases respectively in the control group and in the treatment group,and there was no significant difference on the total efficacy rate,the rate of progress and the rate of fever between the control group and the treatment group (all P > 0.05).There were 14 patients and 6 patients terminated treatment because of adverse reaction,and the difference was significant (29.8% vs 11.8%,P =0.027).The side effect rates of hepatic and renal impairment in the control group was significantly higher than that in the treatment group(27.7% (13/47) vs 11.8% (6/51),P =0.047).Conclusion The efficacy of 25-30 mg per day's amphotericin B treatment is not lower than amphotericin B at 50-60 mg per day on IFI in hematologic malignancies.It is not only relatively safe and less expensive,but also operability and practicality in the treatment of IFI.