伏立康唑与两性霉素B脂质体治疗艾滋病合并播散性马尔尼菲青霉菌病的对照研究

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。

Comparative study of voriconazole and liposomal amphotericin B in the treatment of disseminated penicilliosis marneffei in patients with acquired immunodeficiency syndrome

Objective To compare the efficacy and safety of voriconazole and liposomal amphotericin B in the treatment of disseminated penicilliosis marneffei (PSM) in patients with acquired immuno deficiency syndrome (AIDS).Methods Fifty-two AIDS patients complicated with disseminated PSM infection were enrolled in the study.Of them,20 patients received voriconazole and 32 received liposomal amphotericin therapy.The course of treatment was 28 days.The efficacy and safety between the two groups were compared.Results Th...