Cheung T W, Matta R, Neibart E, Hammer G, Chusid E, Sacks H S, Szabo S, Rose D
Division of Infectious Diseases, Mount Sinai Medical Center, New York, New York 10029.
Clin Infect Dis. 1993 Jan;16(1):22-5. doi: 10.1093/clinids/16.1.22.
We retrospectively reviewed the charts of 96 patients infected with human immunodeficiency virus (HIV) who received intramuscular pentamidine for the prevention of Pneumocystis carinii pneumonia (PCP). These patients, all of whom had either a history of PCP or a CD4 lymphocyte count of < or = 0.2 x 10(9)/L, were intolerant of sulfa drugs, neutropenic, or intolerant of aerosolized treatment. Intramuscular pentamidine was given monthly by the Z-track technique at a dosage of 300 mg (4 mg/kg if the patient weighed < 50 kg). During a total of 350 months of primary prophylaxis in 47 patients and 426 months of secondary prophylaxis in 49 patients, only three cases of PCP occurred. More than 73% of the patients were receiving zidovudine concomitantly. Adverse reactions to intramuscular pentamidine included two episodes of hypotension, three of sterile abscess, two of glucose intolerance, and one of asymptomatic hypoglycemia. The administration of intramuscular pentamidine by the Z-track technique for PCP prophylaxis appears to be highly effective and minimally toxic.
我们回顾性地查阅了96例感染人类免疫缺陷病毒（HIV）患者的病历，这些患者接受了肌肉注射喷他脒以预防卡氏肺孢子虫肺炎（PCP）。这些患者均有PCP病史或CD4淋巴细胞计数≤0.2×10⁹/L，对磺胺类药物不耐受、中性粒细胞减少或不能耐受雾化治疗。采用Z形注射法每月肌肉注射喷他脒，剂量为300mg（如果患者体重<50kg，则为4mg/kg）。在47例患者进行的总计350个月的一级预防和49例患者进行的426个月的二级预防期间，仅发生了3例PCP。超过73%的患者同时接受齐多夫定治疗。肌肉注射喷他脒的不良反应包括2次低血压发作、3次无菌性脓肿、2次葡萄糖不耐受和1次无症状低血糖。采用Z形注射法肌肉注射喷他脒预防PCP似乎非常有效且毒性极小。
