关键词: 两性霉素B, 隐球菌性脑膜脑炎, 不良事件

Abstract: Objective To analyze the clinical characteristics and adverse events of amphotericin B in the treatment of AIDS patients with cryptococcal meningitis, and to find out the factors risk adverse events, so as to provide reference for clinical practice. Methods The basic data of hospitalized AIDS patients with cryptococcal meningitis diagnosed in our hospital from January 2017 to December 2018 were retrospectively analyzed. The Results of laboratory examination, drug treatment plan and adverse events were collected and analyzed. Results The average age of 40 AIDS patients with cryptococcal meningitis was (40.54±15.42) years, the length of stay was (32.67±12.22) d, 30 cases (75%) were elevated intracranial pressure, 37 cases (92.5%) were positive for Cryptococcal neoformans antigen, 92.5% cases were positive for CSF culture, 31 cases (77.5%) were positive for CSF culture, and 92.5% cases were positive for ink smear in cerebrospinal fluid, respectively. Amphotericin B combined with fluorocytosine was selected as the treatment regimen in the induction period. During the treatment, the most adverse events were anemia in 22 cases (55.0%), followed by hypokalemia in 17 cases (42.5%); HGB and blood potassium indexes were significantly abnormal in the second week of drug use, and creatinine, total bilirubin and alanine aminotransferase indexes were significantly abnormal in the first week of drug use. The cumulative dose of amphotericin B > 500mg and HGB < 110 g/L before treatment were the influencing factors leading to the treatment course <14 d, and the difference was statistically significant (P=0.001, P=0.006). Conclusion There are different adverse events in the treatment of AIDS and cryptococcal meningitis at different time points during the treatment of amphotericin B. The main influence factors are cumulative dosage and HGB level before treatment.

Key words: amphotericin B, cryptococcal meningitis, adverse events