两性霉素B脂质体联合氟康唑治疗早产儿真菌性中枢感染研究

摘要

目的 探讨两性霉素B脂质体联合氟康唑治疗早产儿真菌感染的疗效及安全性.方法 收集2009.10 - 2011.5收治的中枢神经系统真菌感染早产儿7例,均应用两性霉素B脂质体联合氟康唑治疗,总疗程8 ～ 12周,监测治疗过程中患儿临床症状、体征及相关的血清学、脑脊液及影像学检查指标.结果 两性霉素B脂质体联合氟康唑足量长疗程治疗使早产儿真菌感染得到良好控制,除1例放弃治疗外,余6例症状明显改善,血培养均转阴,中枢神经系统病灶较前明显改善.治疗过程中未发现较严重的药物不良反应.结论 两性霉素B脂质体联合氟康唑治疗早产儿真菌性中枢感染有效且相对安全.%Objective To study the therapeutic effects and security of liposomal amphotericin B in the treatment of fungul infections in premature neonates. Methods Seven premature neonates with central nervous system (CNS) fungal infectious were admitted from 2009.10 to 2011.5, and were treated with the combination of liposomal amphotericin B and fiuconazole. Their clinical, serologic, cerebrospinal and radiographic data were monitored during 8 - 12 week treatment process. Results Long course and full dose treatment with the combination of liposemal amphotericin B and fluconazole could well control the CNS fungal infections of premature neonates. The symptom improved significantly in all except one case who abandoned the treatment. The result of blood culture turned to be negative. The radiographic images showed that the CNS lesions improved in most cases. No serious adverse drug reactions were observed.Conclusions The combination of liposomal amphotericin B and fluconazole is a relatively safe and effective treatment in CNS fungal infections of premature neonates.