两性霉素B或其脂质体联合葡萄糖酸锑钠治疗难治性黑热病4例报告

Amphotericin B or its liposome combined with antimony sodium gluconate in the treatment of refractory Kala-azar:a report of 4 cases

目的:探讨两性霉素B或其脂质体联合葡萄糖酸锑钠(锑剂)治疗难治性黑热病的效果。方法:回顾性分析兰州大学第一医院确诊收治的4例锑剂治疗后复发或耐锑剂(又称抗锑性)的黑热病患者的临床病历资料,包括患者的性别、年龄等一般情况,院外诊疗过程,临床表现,治疗方法及疗效等。结果:4例患者采用两性霉素B或其脂质体联合锑剂治疗后临床症状均缓解,复查骨髓涂片均未检出利杜体,随访6个月均无复发。结论:两性霉素B或其脂质体联合锑剂可成功治疗难治性黑热病。

Objective:To investigate the effect of amphotericin B or its liposomes combined with antimony sodium gluconate(antimonial)in the treatment of refractory Kala-azar.Methods:Four patients with Kala-azar who relapsed or were resistant to antimony after treatment were admitted to the First Hospital of Lanzhou University.The clinical medical records were retrospectively analyzed,including the general information(gender,age,etc),diagnosis and treatment process,clinical manifestations,treatment methods and treatment effect.Results:The clinical symptoms of four patients were relieved after treatment with amphotericin B or its liposomes combined with antimonial.Reexamination of bone marrow smear showed no Leishman-Donovan body.There was no recurrence after six months of follow-up.Conclusion:Amphotericin B or its liposomes combined with antimonial can be used in the treatment of refractory Kala-azar.