用三或L-AmB进行侵入性阿斯伯吉洛症的初级治疗:一项多中心回顾性研究
Matteo Rinaldi1,2, Russell Edward Lewis3, Maria Chiara Susini2
1Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Open forum infectious diseases
|February 6, 2026
概括
脂质体安福特里辛B (L-AmB) 和活性菌三醇显示了侵入性阿斯伯吉洛症 (IA) 的90天生存率相似. L-AmB耐受性良好,但需要进一步的研究来证实其对IA患者结果的影响.
科学领域:
- 菌类学 菌类学是指菌类学.
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
背景情况:
- 侵入性阿斯伯吉洛症 (IA) 是一种严重的真菌感染,特别是在免疫功能低下的患者中.
- 主要的治疗方案包括脂质体安福特里辛B (L-AmB) 和菌活性三醇.
- 关于这些初级治疗的临床结果的比较数据对于优化患者护理至关重要.
研究的目的:
- 为了比较IA患者用L-AmB治疗的临床结果与作为主要治疗的模具活性三醇.
- 为了评估接受L-AmB或三醇治疗IA的患者的90天全因死亡率.
主要方法:
- 追溯性研究包括401名成年患者,在10年内从两个学术医院获得了已证实或可能的IA.
- 主要终点:90天全因死亡率. 在诊断后的第7天使用了里程碑式的试验仿真.
- 使用治疗权重的反向概率 (IPTW) 和考克斯回归来调整根据适应症的混.
主要成果:
- 在三醇 (58.8%) 和L-AmB (53.3%) 组 (P = .3) 之间,90天的整体生存率相似.
- 接受L-AmB治疗的患者更有可能改变治疗 (63.8% vs 17.2%),通常是口服三醇.
- 对90天死亡率的调整后危险比,将L-AmB与三醇进行比较,为1.43 (95% CI,0.87-2.33;P = .61).
结论:
- 对IA的初级L-AmB治疗耐受性良好,并显示了与菌活性三醇相比的生存率.
- 在两个治疗组之间没有观察到90天死亡率的显著差异.
- 需要进一步的研究,以充分阐明初级L-AmB治疗对IA患者结果的影响.
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