| 自身免疫性疾病患者使用复方磺胺甲噁唑预防卡氏肺孢子菌病研究进展 |
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| 引用本文： | 阙咏图,李鹏冲,张奉春.自身免疫性疾病患者使用复方磺胺甲噁唑预防卡氏肺孢子菌病研究进展[J].协和医学杂志,2023,14(1):196-202. |
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| 作者姓名： | 阙咏图 李鹏冲 张奉春 |
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| 作者单位： | 1.中国医学科学院北京协和医院风湿免疫科 风湿免疫病学教育部重点实验室，北京 100370 |
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| 摘 要： | 随着糖皮质激素、免疫抑制剂、小分子靶向药物及生物制剂的应用，自身免疫性疾病患者由于卡氏肺孢子菌机会性感染发生卡氏肺孢子菌病(pneumocystis carini pneumonia，PCP)的风险明显增加，且此类PCP较艾滋病相关PCP进展快、死亡率高。磺胺类药物是PCP的一线治疗药物，诸多学者提倡自身免疫性疾病患者长期使用复方磺胺甲噁唑(trimethoprim-sulfamethoxazole，TMP-SMZ)预防PCP，但该药物不良反应及耐药性问题不容忽视。本文就自身免疫性疾病患者发生PCP的危险因素、使用TMP-SMZ预防PCP的有效性以及药物不良反应、耐受性、耐药性进行综述。
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| 关 键 词： | 自身免疫性疾病 卡氏肺孢子菌病 复方磺胺甲噁唑 |
| 收稿时间： | 2022-03-20 |
Analysis on Prophylaxis of Pneumocystis Carini Pneumonia by Trimethoprim-Sulfamethoxazole in Patients with Autoimmune Diseases |
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| Institution: | 1.Department of Rheumatology and Immunology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China2.Department of Rheumatology and Immunology, Dongguan Kanghua Hospital, Dongguan, Guangdong 523000, China |
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| Abstract: | The incidence of the opportunistic infection of pneumocystis carini pneumonia(PCP) in patients with autoimmune diseases has increased over recent years, because of the use of glucocorticoids, immunosuppressants, small molecule targeted drugs and biological agents. This group of patients show more rapid progress and higher mortality than human immunodeficiency virus positive patients with PCP. Sulfonamide is the first-line treatment for PCP. Many scholars advocate taking trimethoprim-sulfamethoxazole(TMP-SMZ) for prophylaxis of PCP. However, the adverse effects of sulfonamides and drug resistance cannot be ignored. This article reviews the risk factors for the development of PCP in patients with autoimmune diseases, the effectiveness of PCP prevention with TMP-SMZ, and adverse drug reactions, tolerance, and drug resistance. |
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