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三唑类药物预防血液病患者侵袭性真菌感染的研究进展
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Abstract:
侵袭性真菌感染是免疫功能低下患者发病和死亡的主要原因，尤其是在那些造血干细胞移植、器官移植或者接受化疗的急性白血病患者中更为常见。三唑类抗生素是侵袭性感染的主要预防或治疗药物，其抗菌谱广、毒性较小、耐受性较好，用于治疗念珠菌和曲霉菌，特别是免疫缺陷型患者中的常见药物，可显著降低其死亡率。但由于其本身也作用于哺乳动物细胞色素P450酶系，易与其他药物发生相互作用产生毒性。本文综述了三唑类药物(伊曲康唑、氟康唑、伏立康唑、泊沙康唑和艾沙康唑)的作用方式及药物相互作用、药物治疗监测等，并强调了其相似性和差异性的临床意义。
Fungal infections are a major cause of morbidity and mortality in immunocompromised patients, especially in those undergoing hematopoietic stem cell transplantation, organ transplantation, or acute leukemia undergoing chemotherapy. Triazole antibiotics are the main prophylactic or therapeutic drugs for invasive infections. However, they feature a broad antimicrobial spectrum, minimal toxicity, and good tolerability. It is used to treat candidiasis and aspergillosis, particularly in immunocompromised patients, where it can significantly reduce mortality rates. However, because they also act on the mammalian cytochrome P450 enzyme line, it is easy to interact with other drugs to produce toxicity. This review summarizes the mode of action, drug interaction, and therapeutic monitoring of triazole drugs (itraconazole, fluconazole, voriconazole, posaconazole, and oxaconazole), and highlights the clinical significance of the similarities and differences.
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