中华实验和临床感染病杂志(电子版)
中華實驗和臨床感染病雜誌(電子版)
중화실험화림상감염병잡지(전자판)
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2014年
6期
807-811
,共5页
赵建荣%芮少军%彭干成%张恩俊%王颖
趙建榮%芮少軍%彭榦成%張恩俊%王穎
조건영%예소군%팽간성%장은준%왕영
伏立康唑%两性霉素B%氟康唑%诱导治疗%隐球菌性脑膜炎%人类免疫缺陷病毒/获得性免疫缺陷综合征
伏立康唑%兩性黴素B%氟康唑%誘導治療%隱毬菌性腦膜炎%人類免疫缺陷病毒/穫得性免疫缺陷綜閤徵
복립강서%량성매소B%불강서%유도치료%은구균성뇌막염%인류면역결함병독/획득성면역결함종합정
Voriconazol%Amphotericin B%Fluconazole%Induction therapy%Cryptococcal meningitis%Human immunodeifciency virus/acquired immunodeifciency syndrome (HIV/AIDS)
目的:观察伏立康唑联合两性霉素B诱导治疗HIV感染者新型隐球菌性脑膜炎的疗效与安全性,探索一种有益和有效的诱导治疗方法。方法采用回顾性对比分析,选择25例患者入组,其中研究组(伏立康唑联合两性霉素B诱导治疗)5例,对照组(两性霉素B联合氟康唑诱导治疗)20例,比较分析两组患者治疗过程中临床症状、体征及脑脊液生化改善情况,治疗后1周和2周病原学阴转情况,病死率,血清白细胞、血小板及电解质水平的变化,肝肾功能改变等。结果研究组与对照组在临床表现改善及脑脊液生化、脑脊液病原微生物阴转率(第1周:1/3 vs 2/16,χ2=0.824、P=0.364;第2周:3/5 vs 5/20,χ2=2.252、P=0.133)、急性期病死率(1/5 vs 2/20,χ2=0.379、P=0.538)、Ⅲ级以上实验室不良反应方面(2/5 vs 3/20,χ2=1.565、P=0.211),差异均无统计学意义。结论伏立康唑联合两性霉素B诱导治疗HIV感染者隐球菌性脑膜炎,疗效确切、安全,是一种可供选择的治疗方案。
目的:觀察伏立康唑聯閤兩性黴素B誘導治療HIV感染者新型隱毬菌性腦膜炎的療效與安全性,探索一種有益和有效的誘導治療方法。方法採用迴顧性對比分析,選擇25例患者入組,其中研究組(伏立康唑聯閤兩性黴素B誘導治療)5例,對照組(兩性黴素B聯閤氟康唑誘導治療)20例,比較分析兩組患者治療過程中臨床癥狀、體徵及腦脊液生化改善情況,治療後1週和2週病原學陰轉情況,病死率,血清白細胞、血小闆及電解質水平的變化,肝腎功能改變等。結果研究組與對照組在臨床錶現改善及腦脊液生化、腦脊液病原微生物陰轉率(第1週:1/3 vs 2/16,χ2=0.824、P=0.364;第2週:3/5 vs 5/20,χ2=2.252、P=0.133)、急性期病死率(1/5 vs 2/20,χ2=0.379、P=0.538)、Ⅲ級以上實驗室不良反應方麵(2/5 vs 3/20,χ2=1.565、P=0.211),差異均無統計學意義。結論伏立康唑聯閤兩性黴素B誘導治療HIV感染者隱毬菌性腦膜炎,療效確切、安全,是一種可供選擇的治療方案。
목적:관찰복립강서연합량성매소B유도치료HIV감염자신형은구균성뇌막염적료효여안전성,탐색일충유익화유효적유도치료방법。방법채용회고성대비분석,선택25례환자입조,기중연구조(복립강서연합량성매소B유도치료)5례,대조조(량성매소B연합불강서유도치료)20례,비교분석량조환자치료과정중림상증상、체정급뇌척액생화개선정황,치료후1주화2주병원학음전정황,병사솔,혈청백세포、혈소판급전해질수평적변화,간신공능개변등。결과연구조여대조조재림상표현개선급뇌척액생화、뇌척액병원미생물음전솔(제1주:1/3 vs 2/16,χ2=0.824、P=0.364;제2주:3/5 vs 5/20,χ2=2.252、P=0.133)、급성기병사솔(1/5 vs 2/20,χ2=0.379、P=0.538)、Ⅲ급이상실험실불량반응방면(2/5 vs 3/20,χ2=1.565、P=0.211),차이균무통계학의의。결론복립강서연합량성매소B유도치료HIV감염자은구균성뇌막염,료효학절、안전,시일충가공선택적치료방안。
Objective To investigate the efifcacy and safety of voriconazole combined amphotericin B (AmB)-based induction therapy in HIV/AIDS associated cryptococcal meningitis for two weeks, and evaulate the value of combination therapy in cryptococcal meningitis. Methods Total of 25 patients with HIV/AIDS associated cryptococcal meningitis were divided into two groups for two weeks duration:patients in the study group (5 cases) were given the treatment of AmB (0.5 mg/kg) and voriconazole (6 mg/kg twice, and then 4 mg/kg twice daily); while patients in the control group (20 cases) were given the treatment of AmB (0.5 mg/kg) and lfuconazole (400 mg/d, double dose at ifrst). The clinical symptoms, signs, the rate of clearance of infection from the cerebrospinal lfuid (CSF), fatality rate and laboratory adverse events of the two groups were compared, respectively. Results There were no signiifcant differences between the two groups in recovery of fever, headache and biochemistry of CSF. Moreover, the rate of clearance of cryptococcal colony-forming units (CFU) in CSF samples (after 1 week:1/3 vs 2/16,χ2=0.824, P=0.364;after 2 weeks:3/5 vs 5/20,χ2=2.252, P=0.133) and the fatality rate (1/5 vs 2/20,χ2=0.379, P=0.538) were not signiifcant different in the two groups. There were no signiifcant differnet in the two group for the laboratory adverse (≥grade 3) (2/5 vs 3/20, χ2=1.565, P=0.211). Conclusions Voriconazole plus AMB is an effective and safe alternative as induction therapy in HIV-infected with cryptococcal meningitis patients not receiving interacting medications.