关键词: 两性霉素B, 恶性血液病, 侵袭性真菌病

Abstract:

Objective To evaluate the efficacy and safety of domestic amphotericin B or in combination with other antifungal drugs in malignant hematologic patients with invasive fungal disease (IFD). Methods A retrospective clinical analysis was performed based on 54 patients with hematologic malignancies who firstly infected IFD were treated by amphotericin B or combinated with other antifungal drugs during April 2013 and April 2016 in our department. Results Overall response rate was 88.9%. The response rates of amphotericin B, amphotericin B combined with voriconazole, amphotericin B combined with caspofungin were 76.2% (16/21 cases),96.4% (27/28 cases),100% (5/5 cases). The main risk factors of the patients were the recovery of neutrophils and smoking history (P<0.05). The common lung CT findings of the patients were patchy ground glass shadow 63.0% (34/54 cases), consolidation 11.1% (6/54 cases), nodule 14.8% (8/54 cases). The major adverse reactions of the patients were hypokalemia, liver damage. Conclusion The domestic amphotericin B for malignant hematologic patients with IFD are economic, safe and effective antifungal drugs.If it is ineffective,then combined with other antifungal drugs can enhance curative effect. Although increased incidence of adverse reactions, but they can be controlled, so as to achieve more aggressive antifungal treatment, improve the treatment effectiveness and reduce the case fatality rate.

Key words: amphotericin B, hematologic malignancies, invasive fungal disease