Moreau P, Milpied N, Fayette N, Ramée J F, Harousseau J L
Department of Haematology, CHU Hôtel Dieu, Nantes, France.
J Antimicrob Chemother. 1992 Oct;30(4):535-41. doi: 10.1093/jac/30.4.535.
The clinical use of amphotericin B is sometimes limited by nephrotoxicity. In a randomized prospective study, 32 patients treated for haematological malignancies received either amphotericin B in 5% dextrose (group A, 16 patients, 0.7-1 mg/kg/day), or amphotericin B mixed with Intralipid (group B, 16 patients, 0.7-1 mg/kg/day) during prolonged neutropenia. Renal dysfunction occurred in 9/16 patients in group A and 2/16 patients in group B (P < 0.05). Clinical tolerance was improved with a reduction of fever with chills in 12/16 patients in group A compared with 5/16 in group B (P < 0.05). Preparation of amphotericin B with Intralipid reduces nephrotoxicity, improves clinical tolerance, may allow an increase in the daily dose of amphotericin B, and be an alternative to liposomal-amphotericin B infusion.
两性霉素B的临床应用有时会受到肾毒性的限制。在一项随机前瞻性研究中，32例接受血液系统恶性肿瘤治疗的患者在长期中性粒细胞减少期间，分别接受5%葡萄糖溶液配制的两性霉素B（A组，16例患者，0.7 - 1mg/kg/天）或与脂质乳混合的两性霉素B（B组，16例患者，0.7 - 1mg/kg/天）治疗。A组16例患者中有9例出现肾功能障碍，B组16例患者中有2例出现肾功能障碍（P<0.05）。A组16例患者中有12例寒战发热减轻，临床耐受性得到改善，而B组16例患者中只有5例（P<0.05）。用脂质乳配制两性霉素B可降低肾毒性，提高临床耐受性，可能允许增加两性霉素B的每日剂量，并且可作为脂质体两性霉素B输注的替代方法。
