氟康唑治疗9例隐球菌脑膜炎分析

目的研究氟康唑治疗新型隐球菌性脑膜炎的疗效。方法9例都给予氟康唑400mg静脉滴注,1次/d;其中1例53d后改为200mg口服1次/d;另2例120d后改为200mg口服1次/d,5例给氟康唑200mg静脉滴注,1次/d。结果9例隐球菌脑莫炎患者应用氟康唑治疗,除1例死亡,其余8例都取得良好效果,无出现严重的不良反应。结论两性霉素B是系统性抗真菌治疗的金标准,对隐球菌脑膜炎首选,但由于肝、肾毒性大,很多患者不能耐受;氟康唑作为补救治疗首选方案,早期足量长疗程应用氟康唑可以用于治疗绝大多数新型隐球菌脑膜炎患者。

Analysis of 9 cases of cryptococcal meningitis treated by fluconazol

Objective To rearcb the effects of fluconazol in treating the cryptococcal meningitis. Methods All of 9 cases were treated with fluconazol by intervenous drop infusion, （400 mg/day）. Only one of them had been changed for oral fluconazol （200 mg/day） after 53 days： and two of them had been changed for oral fluconazol （200 mg/day） after 120 days： and five of them had been changed for fluconazol by intervenous drop infusion （200 mg/day） after 120 days ： Results Only one of the 9 cases of cryptococcal meningitis treated by fluconazol had been dead. The other 8 cases gained well effect, and there is no severe adverse effect. Conclusions Amphotericin B is the gold standard of systemic anti-fungus therapy and it is the first election of cryptococcal meningitis. But many patients can＇t tolerate it because its severe hepatotoxicity and renal toxicity. Fluconazol is the first elective scheme of salvage therapy. The majority of cryptocoecal meningitis patients will be cured if they are treated with fluconazol in early stage by full dosage and long time of therapy.