国产两性霉素B脂质体不同加量方案在艾滋病合并马尔尼菲篮状菌感染患者中的安全性

The Safety of Domestic Amphotericin B Liposome with Different Dosage Regimens in Patients with AIDS Combined with Talaromyces marneffei Infection

目的探索国产两性霉素B脂质体临床应用中不同加量方案的安全性、常见不良反应及其影响因素。方法收集2017年1月—2022年12月我院收治的使用国产两性霉素B脂质体的艾滋病合并马尔尼菲篮状菌感染的病例,收集患者的基本资料、对比两性霉素B脂质体不同加量方案对血常规、肝肾功能及低钾血症的影响,统计发生的药品不良反应并使用多重线性回归法对用药后钾离子浓度的影响因素进行分析。结果共纳入50例患者,快速加量法(n=23,≤4d)与慢速加量法(n=27,>4d)对血常规、肝肾功能及钾离子浓度的影响均差异无统计学意义(P>0.05)。低钾血症(76.0%)是两性霉素B脂质体最常见不良反应,多重线性回归分析显示用药前钾离子浓度(P=0.008)是用药后钾离子浓度的重要影响因素。结论国产两性霉素B脂质体可安全使用快速加量法以尽快达到治疗剂量,该药临床应用中最常见不良反应为低钾血症,用药前钾离子浓度是用药后钾离子浓度的重要影响因素。

Objective To explore the safety of different dosage regimens of domestic amphotericin B liposomes in clinical application,as well as the common adverse drug reactions and their influencing factors.Methods Between January 2017 and December 2022,information about patients with AIDS and Talaromyces marneffei infections at our hospital was gathered.The fundamental data,the impacts of various amphotericin B liposome dose regimens on the blood system,liver and kidney function,potassium concentration,and the factors influencing potassium concentration were examined.Results A total of 50 patients were included.There was no statistically significant difference between the effects of rapid dosing(n=23,≤4d)and slow dosing(n=27,>4d)on haematology,hepatic and renal function,and potassium ion concentration(P>0.05).Hypokalemia(76.0%)was the most common adverse reaction.There were no significant differences between the different dosage regimens on the blood system,liver and kidney function and potassium concentration(P>0.05).Multiple linear regression analysis showed that potassium concentration before administration(P=0.008)was an important factor affecting hypokalemia induced by amphotericin B liposome.Conclusion For domestic amphotericin B liposomes,a rapid dosage regimen can be employed safely to get the therapeutic dose as quickly as possible.The most common adverse reaction is hypokalemia.Potassium concentration before medication is an important factor affecting hypokalemia.