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[侵袭性曲霉病的治疗]

[Treatment of invasive aspergillosis].

作者信息

Martino P

机构信息

Cattedra di Ematologia, Università degli Studi di Roma La Sapienza, Italien.

出版信息

Mycoses. 1994;37 Suppl 2:20-6.

PMID:7609739
Abstract

With the increasing use of aggressive chemotherapy in patients with malignancies causing prolonged periods of granulocytopenia and severe mucosal damage and the progresses made in the prophylaxis and treatment of bacterial infections, the risk of invasive mycosis has increased particularly in patients with haematologic malignancies. Invasive aspergillosis used to occur almost exclusively in leukaemic patients. More recently the incidence of Aspergillus infections in these patients has increased and it also occurs in other immunocompromised hosts, such as patients with solid tumors or AIDS. Experiences from various institutions indicate a frequency of 10-30% for aspergillosis in leukaemic patients. Amphotericin B has been considered the standard antifungal in the therapy of aspergillosis in immunocompromised hosts. There is, however, some evidence that amphotericin B is not always effective in aspergillosis especially during neutropenia. Initial clinical studies of itraconazole in patients with aspergillosis showed promising activity of this new triazole compound.

摘要

随着侵袭性化疗在恶性肿瘤患者中的使用增加,导致粒细胞缺乏期延长和严重黏膜损伤,以及在细菌感染的预防和治疗方面取得进展,侵袭性真菌病的风险尤其在血液系统恶性肿瘤患者中有所增加。侵袭性曲霉病过去几乎只发生在白血病患者中。最近,这些患者中曲霉菌感染的发生率有所增加,并且也发生在其他免疫功能低下的宿主中,如实体瘤患者或艾滋病患者。各机构的经验表明,白血病患者中曲霉病的发生率为10% - 30%。两性霉素B一直被认为是免疫功能低下宿主曲霉病治疗中的标准抗真菌药物。然而,有一些证据表明两性霉素B在曲霉病治疗中并不总是有效,尤其是在中性粒细胞减少期间。伊曲康唑在曲霉病患者中的初步临床研究显示了这种新的三唑类化合物有良好的活性。

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