两性霉素B治疗侵袭性肺部真菌感染的临床分析

Clinical analysis of domestic amphotericin B on pulmonary invasive fungal infection

目的分析两性霉素B治疗ICU内侵袭性真菌感染的疗效与不良反应。方法回顾性分析98例合并侵袭性肺部真菌感染的重症患者接受两性霉素B微泵静脉给药的临床资料。结果两性霉素B的临床有效率77.55%,真菌清除率75.51%。不良反应包括寒战发热(9.18%)、皮疹(4.08%)、静脉炎(1.02%)、恶心呕吐(6.12%)、低钾血症(16.32%)、肝损害(1.02%)和肾损害(4.08%)。结论国产两性霉素B对于重症患者侵袭性真菌感染疗效确定,采用持续微泵静脉给药不良反应发生率低。

Objective To analysis the therapeutic afficacy and adverse reactions of domestic amphotericin B on pulmonary invasive fungal infection in ICU.Methods Domestic amphotericin B was injected with steady speed by an intravenous injection pump.A total of 98 cases with pulmonary invasive fungal infection in ICU were reviewed.Results The clinical efficacy of domestic amphotericin B on the proven,the probable and the possible patients with invasive fungal infection was 28.57%,58.33% and 84.81% （P 〈0.01）.The fungus clearance of domestic amphotericin B on the proven,the probable and the possible patients was 28.57%,41.67% and 84.81% （P 〈0.01）.The adverse reactions included shiver and fever （9.18%）,skin rash （4.08%）,phlebitis （1.02%）,nausea and vomiting （6.12%）,hypokalaemia （16.32%）,hepatic damage （1.02%） and renal impairment （4.08%）.The adverse reaction occurred lowest when the daily dose was 0.5 ～ 0.8 mg · Kg-1 · d-1,but highest when the daily dose was 1.2 ～ 1.5mg · Kg-1 · d-1 （P 〈 0.05）.Conclusions Domestic amphotericin B is affirmed in the therapy for IFI in ICU patients with tolerable adverse reactions by intravenous injection continuously.