论文部分内容阅读
目的比较伏立康唑和两性霉素B脂质体治疗艾滋病(AIDS)合并播散性马尔尼菲青霉菌病(PSM)的疗效及安全性。方法对经血/骨髓培养确诊为AIDS合并PSM的患者,分别给予伏立康唑和两性霉素B脂质体治疗,疗程28d,比较两组的疗效和安全性。结果共52例患者纳入研究,其中伏立康唑治疗组20例,两性霉素B脂质体治疗组32例。治疗14d和28d时,伏立康唑组和两性霉素B脂质体组的治疗有效率分别为40.0%、65.0%和56.3%、71.9%,两组比较差异均无统计学意义(Z=1.300,P=0.254;Z=0.273,P=0.601),但两组28d的治疗有效率均明显高于14d(Z=3.994,P=0.046)。治疗过程中,两组均未出现因毒副作用停药的现象,但两性霉素B脂质体组临床毒副反应较重且出现了血清肌酐的升高。结论伏立康唑与两性霉素B脂质体均为治疗AIDS合并PSM的有效方法,但伏立康唑安全性更好。
Objective To compare the efficacy and safety of voriconazole and amphotericin B liposomes in the treatment of AIDS with disseminated Penicillium marneffei (PSM). Methods The patients diagnosed as AIDS complicated with PSM by menstruation / bone marrow culture were treated with voriconazole and amphotericin B liposomes respectively for 28 days. The curative effect and safety of the two groups were compared. Results A total of 52 patients were enrolled in the study, including 20 patients in the voriconazole treatment group and 32 patients in the amphotericin B liposome treatment group. The therapeutic effective rates of voriconazole group and amphotericin B liposome group were 40.0%, 65.0% and 56.3%, 71.9% on the 14th and 28th day after treatment, respectively, with no significant difference between the two groups (Z = 1.300, P = 0.254; Z = 0.273, P = 0.601). However, the therapeutic effective rates of 28 days in both groups were significantly higher than those in 14 days (Z = 3.994, P = 0.046). During the course of treatment, no side effects of drug withdrawal were observed in both groups, but clinical side effects of amphotericin B liposomes were severe and serum creatinine increased. Conclusions Both voriconazole and amphotericin B liposomes are effective methods for the treatment of AIDS complicated with PSM, but voriconazole is more safe.