两性霉素B和5—氟胞嘧啶联合用药对肝、肾功能的影响

目的：探讨两性霉素B（AMB）和5－氟胞嘧啶（5－FC）联合治疗新型隐球菌性脑膜炎对肝、肾功能的影响。方法：用AMB联合5－FC治疗新型隐球菌性脑膜炎患赌40例，观察用药后肝、肾功能的变化。结果：治疗患 者中有75％（30／40）出现ALT升高，55％（22／40）出现AST升高，仅有12.5％（5／40）出现血清总胆红素升高。分别有47.5％（19／40）和20％（8／40）的患者出现血尿素氮和血肌酐异常。结论：AMB联合5－FC治疗新型隐球菌性脑膜炎对中毒性肝炎的发生率高，但不引起严重的中毒性肝损害。对肾脏的毒性表现为氮质血症，尿毒性的发生率低。

Influence on liver and kidney from combined amphotericin B and flucytosine

AIM: To observe the influence on liver and kidney form amphotericin B combined flucytosine in the treatment of cryptococcus meningitis. METHODS: Forty patients with cryptococcus meningitis treated by amphotericin B combined flucytosine were evaluated. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubine (TBIL), blooduria nitrogen (BUN) and creatinine (Cr) of the patients' blood serum were observed regularly after treatment. RESULTS: The results showed that 75% (30/40) and 55% (22/40) patients appeared increasing of ALT and AST level respectively, and only 12 5% (5/40) patients appeared increasing of TBIL level. And 47 5% (19/40) and 20% (8/40) patients appeared increasing of BUN and Cr level respectively. CONCLUSION: The incidence rate of toxic hepatitis from amphotericin B combined with flucytosine in the treatment of cryptococcus meningitis is high, but the severity is light. The main influence on kidney from amphotericin B combined with flucytosine in the treatment of the patients with cryptococcus meningitis is azotemia. The incidence rate of uremia is very low.