33例艾滋病伴播散性马尔尼菲青霉菌病患者的临床分析及其对抗真菌治疗的影响

Clinical Analysis on 33 AIDS Patients with Disseminated Penicilliosis Marneffei Disease and Its Influence on Anti-fungal Therapy

目的:探究福建泉州地区艾滋病患者伴播散性马尔尼菲青霉菌病的特点、特征以及治疗效果。方法:抽取2014年1月1日—2017年12月31日间收治的艾滋病伴播散性马尔尼菲青霉病患者33例资料,按治疗方法的不同将其分为两性霉素治疗组19例和伏立康唑治疗组14例;分析其患者的发病时间、临床症状、体征发生的特点,以及抗真菌治疗后存活率的差异。结果:经两性霉素与伏立康唑分别治疗后,伏立康唑治疗组的存活率高于两性霉素治疗组,但经两组间比较其差异无统计学意义(P>0.05)。结论:艾滋病伴播散性马尔尼菲青霉菌病患者在临床上没有典型的特征,初期发现并及时接受治疗,可有效提高患者的存活率,伏立康唑和两性霉素均为治疗马尔尼菲青霉菌病患者的有效药物,但在艾滋病晚期患者伴马尔尼菲青霉菌病,采用伏立康唑部的安全性较两性霉素有较大的优势。

Objective: To analyze the characteristics, features and therapeutic effects of disseminated Penicilliosis Marneffei with AIDS in Quanzhou area of Fujian. Methods: Data of 33 AIDS patients with disseminated penicillium marneffei admitted from January 1, 2014 to December 31, 2017 were selected. Based on different treatment methods,the data were divided into the amphotericin treatment group(n=19) and the voriconazole treatment group(n=14). The time of onset, clinical symptoms and signs, and the difference of survival rate after antifungal therapy were analyzed.Results: After amphotericin and voriconazole treatment, the survival rate in the voriconazole treatment group was higher than that of the amphotericin treatment group, but the difference between the two groups was not statistically significant(P>0.05). Conclusion: In AIDS patients with disseminated Marneffei penicillium there were on the no typical clinical features, early finding and treatment on time, on can effectively improve the survival of patients;voriconazole or amphotericin were effective drugs for the treatment of Marneffei penicillium patients, but in the late of HIV/AIDS patients with Marneffei penicillium disease, in the safety of the use voriconazole had greater advantage than amphotericin.