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3mg\/kg\uff08\u4f7f\u75282\u5468\uff09\uff0c\u8f7b\u4e2d\u5ea6HIV\u60a3\u8005\u9009\u7528\u4f0a\u66f2\u5eb7\u5511200mg\uff08\u524d3\u5929\u6bcf\u65e53\u6b21\uff0c\u540e\u7eed\u4e3a\u6bcf\u65e52\u6b21\uff09\uff1b\u7ef4\u6301\u6cbb\u7597\u671f\u95f4\uff0c\u4f7f\u7528\u4f0a\u66f2\u5eb7\u5511200mg\uff08\u6bcf\u65e52\u6b21\uff0c\u4f7f\u752812\u4e2a\u6708\uff09<sup>[5]<\/sup>\u3002IDSA\u300a\u7ec4\u7ec7\u80de\u6d46\u83cc\u75c5\u60a3\u8005\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u300b\u4e2d\u5219\u9488\u5bf9\u66f4\u591a\u7c7b\u578b\u7684\u60a3\u8005\u7ed9\u51fa\u4e86\u7528\u836f\u63a8\u8350\uff0c\u5982\u4e0b\u8868\u3002\u88681 IDSA\u6307\u5357\u9488\u5bf9\u7ec4\u7ec7\u80de\u6d46\u83cc\u75c5\u7684\u7528\u836f\u63a8\u8350<sup>[6]<\/sup><\/p>\n<p>\u25a0&nbsp;\u5faa\u8bc1\u8bc1\u636e\uff1a\u4e00\u9879Cochrane\u6570\u636e\u5e93\u7efc\u8ff0\u5728\u7efc\u5408\u5206\u6790\u4e86\u591a\u9879\u7814\u7a76\u7ed3\u679c\u4ee5\u540e\u53d1\u73b0\uff0c\u8fdb\u884c\u6027\u64ad\u6563\u6027\u7ec4\u7ec7\u80de\u6d46\u83cc\u75c5\u7684\u8bf1\u5bfc\u6cbb\u7597\u4e2d\uff0cL-AmB\u76f8\u8f83\u4e8eAmBD\u4e34\u5e8a\u6210\u529f\u7387\u66f4\u9ad8\u3001\u80be\u6bd2\u6027\u66f4\u4f4e<sup>[7]<\/sup>\u3002\u771f\u83cc7\u53f7\uff1a\u6bdb\u9709\u6bdb\u9709\u662f\u4e00\u5927\u7c7b\u5168\u7403\u5206\u5e03\u7684\u81f4\u75c5\u6027\u771f\u83cc\uff0c\u901a\u5e38\u7d2f\u53ca\u80ba\u548c\u9f3b\u7aa6\uff0c\u53ef\u6269\u6563\u81f3\u773c\u775b\u3001\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u548c\u80c3\u80a0\u9053\uff0c\u4e5f\u53ef\u901a\u8fc7\u76ae\u80a4\u7834\u635f\u5904\u548c\u70e7\u4f24\u5904\u6216\u5176\u4ed6\u5916\u4f24\u5904\u4fb5\u5165\u3002\u6bdb\u9709\u75c5\u5c24\u5176\u5f71\u54cd\u514d\u75ab\u529f\u80fd\u4f4e\u4e0b\u8005\uff08\u5982\u764c\u75c7\u60a3\u8005\u548c\u79fb\u690d\u60a3\u8005\uff09\u3001\u7cd6\u5c3f\u75c5\u63a7\u5236\u4e0d\u4f73\u8005\u3001\u521b\u4f24\u60a3\u8005\u7b49\u4eba\u7fa4<sup>[1]<\/sup>\u3002\u25a0&nbsp;\u53d1\u75c5\u7387\uff1a\u5168\u7403\u6bdb\u9709\u75c5\u53d1\u75c5\u7387\u4e0d\u540c\uff0c\u5370\u5ea6\u4e3a1300\/1000000\uff0c\u6b27\u6d32\u4e3a0.2\/1000000\uff08\u4e39\u9ea6\uff09-95\/1000000\u4eba\uff08\u8461\u8404\u7259\uff09\uff0c\u7f8e\u56fd\u4e3a3\/1000000\u4eba<sup>[8]<\/sup>\u3002\u25a0&nbsp;\u6b7b\u4ea1\u7387\uff1a\u6210\u4eba\u60a3\u8005\u7684\u6b7b\u4ea1\u7387\u4e3a23%-80%\uff0c\u513f\u7ae5\u60a3\u8005\u7684\u6b7b\u4ea1\u7387\u9ad8\u8fbe72.7%<sup>[1]<\/sup>\u3002\u25a0&nbsp;\u6cbb\u7597\u65b9\u6848\uff1a\u6bdb\u9709\u901a\u5e38\u5bf9AMB\u654f\u611f\uff0c\u4f46\u4e00\u4e9b\u83cc\u79cd\/\u83cc\u682a\u7684MIC\u53ef\u80fd\u8f83\u9ad8\uff0c\u800c\u5bf9\u6c1f\u5eb7\u5511\u3001\u4f0f\u7acb\u5eb7\u5511\u548c\u68d8\u767d\u83cc\u7d20\u7c7b\u836f\u7269\u5929\u7136\u8010\u836f<sup>[1]<\/sup>\u3002ECMM\u53d1\u5e03\u7684\u300a\u6bdb\u9709\u75c5\u8bca\u65ad\u548c\u7ba1\u7406\u5168\u7403\u6307\u5357\u300b\u5c06L-AmB\u63a8\u8350\u4e3a\u4e00\u7ebf\u6cbb\u7597\uff0c\u8be6\u89c1\u4e0b\u8868\u3002\u88682 ECMM\u6307\u5357\u9488\u5bf9\u6bdb\u9709\u75c5\u7684\u7528\u836f\u63a8\u8350<sup>[9]<\/sup><\/p>\n<p>\u25a0&nbsp;\u5faa\u8bc1\u8bc1\u636e\uff1a\u7cfb\u7edf\u6027\u7efc\u8ff0\u53ca\u835f\u8403\u5206\u6790\u663e\u793a\uff0c\u76f8\u6bd4\u4f20\u7edfAMB\uff0cL-AmB\u572890\u5929\u6b7b\u4ea1\u7387\u66f4\u4f4e\uff0840% vs 35%\uff09\uff0c\u4e0d\u826f\u4e8b\u4ef6\u53d1\u751f\u7387\u663e\u8457\u66f4\u5c11\uff0822% vs 13%\uff09\uff0c\u4e14\u65e0\u8bba\u662f\u4f7f\u75285mg\/kg\/d\u8fd8\u662f\u66f4\u9ad8\u5242\u91cf\uff086-15mg\/kg\/d\uff09\u7684L-AmB\uff0c90\u5929\u6b7b\u4ea1\u7387\u4e5f\u65e0\u663e\u8457\u5dee\u5f02<sup>[10]<\/sup>\u3002\u771f\u83cc8\u53f7\uff1a\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u662f\u4e00\u79cd\u81f4\u75c5\u6027\u53cc\u76f8\u771f\u83cc\uff0c\u5728\u4e1c\u5357\u4e9a\u548c\u4e2d\u56fd\u90e8\u5206\u5730\u533a\u6d41\u884c\uff0c\u53ef\u5f71\u54cd\u80ba\u90e8\uff0c\u4e5f\u53ef\u6269\u5c55\u81f3\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u3001\u8840\u6db2\u548c\u8eab\u4f53\u5176\u4ed6\u90e8\u4f4d\u3002\u4fb5\u88ad\u6027\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u75c5\u5c24\u5176\u5f71\u54cd\u5371\u91cd\u548c\u514d\u75ab\u529f\u80fd\u4f4e\u4e0b\u7684\u60a3\u8005\uff0c\u5982HIV\u3001\u764c\u75c7\u6216\u5668\u5b98\u79fb\u690d\u60a3\u8005<sup>[1]<\/sup>\u3002\u25a0&nbsp;\u53d1\u75c5\u7387\uff1a\u7531\u4e8e\u7f3a\u4e4f\u7814\u7a76\uff0c\u65e0\u6cd5\u8bc4\u4f30\u5168\u7403\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u53d1\u75c5\u7387<sup>[1]<\/sup>\u3002\u25a0&nbsp;\u6b7b\u4ea1\u7387\uff1a\u6210\u4ebaHIV\u611f\u67d3\u8005\u5408\u5e76\u9a6c\u5c14\u5c3c\u975e\u7bee\u72b6\u83cc\u60a3\u8005\u6b7b\u4ea1\u7387\u4e3a12%-21%<sup>[1]<\/sup>\u3002\u25a0&nbsp;\u6cbb\u7597\u65b9\u6848\uff1a\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u75c5\u901a\u5e38\u91c7\u7528AMB\u3001\u4f0a\u66f2\u5eb7\u5511\u6216\u4f0f\u7acb\u5eb7\u5511\u6cbb\u7597\u3002IDSA\u300aHIV\u611f\u67d3\u6210\u4eba\u548c\u9752\u5c11\u5e74\u60a3\u8005\u673a\u4f1a\u6027\u611f\u67d3\u9884\u9632\u548c\u6cbb\u7597\u6307\u5357\u300b\u6307\u51fa\uff0cAMB\u662f\u91cd\u75c7\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u75c5\u7684\u4e00\u7ebf\u6cbb\u7597\u65b9\u6848\uff0c\u521d\u59cb\u6cbb\u7597\u65f6\u53ef\u6301\u7eed\u4f7f\u7528AMB 0.6-1mg\/kg\/d\u81f32\u5468\uff0c\u7ee7\u4ee5\u4f0a\u66f2\u5eb7\u5511400mg\/d\u81f310\u5468\uff0c\u6700\u540e\u4f7f\u7528\u4f0a\u66f2\u5eb7\u5511200mg\/d\u8fdb\u884c\u9884\u9632\uff0c\u76f4\u5230CD4+T\u7ec6\u80de\u8ba1\u6570\uff1e100\/\u03bcL\u81f3\u5c116\u4e2a\u6708<sup>[11]<\/sup>\u3002\u300a\u4e2d\u56fd\u827e\u6ecb\u75c5\u8bca\u7597\u6307\u5357\uff082021\u7248\uff09\u300b\u4e5f\u63d0\u5230\uff0c\u65e0\u8bba\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u5982\u4f55\uff0c\u53ef\u4f18\u9009L-AmB 3-5mg\/kg\/d<sup>[12]<\/sup>\u3002\u25a0&nbsp;\u5faa\u8bc1\u8bc1\u636e\uff1a\u4e00\u9879\u7531\u6d59\u6c5f\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u7b2c\u4e00\u533b\u9662\u5c55\u5f00\u7684\u7cfb\u7edf\u6027\u7efc\u8ff0\u53ca\u835f\u8403\u5206\u6790\u663e\u793a\uff0c\u76f8\u8f83\u4e8e\u4f0a\u66f2\u5eb7\u5511\uff0c\u4f7f\u7528AMB\u4f5c\u4e3a\u521d\u59cb\u6cbb\u7597\u7684\u60a3\u8005\u6b7b\u4ea1\u7387\u663e\u8457\u964d\u4f4e39%\uff08P=0.01\uff09\uff0c\u63d0\u793aAMB\u6216\u4e3a\u521d\u59cb\u6cbb\u7597\u7684\u66f4\u4f18\u9009\u62e9<sup>[13]<\/sup>\u3002\u4e09\u3001\u603b\u7ed3\u8fd1\u5e74\u6765\u9570\u5200\u83cc\u3001\u7ec4\u7ec7\u80de\u6d46\u83cc\u3001\u6bdb\u9709\u4ee5\u53ca\u9a6c\u5c14\u5c3c\u83f2\u7bee\u72b6\u83cc\u7b49\u7f55\u89c1\u83cc\u7684\u53d1\u75c5\u7387\u5448\u4e0a\u5347\u8d8b\u52bf\uff0c\u5df2\u7ecf\u9010\u6b65\u5f15\u8d77\u4e86\u4e34\u5e8a\u7684\u8fdb\u4e00\u6b65\u5173\u6ce8\u3002\u57fa\u4e8e\u76f8\u5173\u6307\u5357\u63a8\u8350\uff0c\u6548\u679c\u597d\u4e14\u5b89\u5168\u6027\u4f73\u7684L-AmB\u53ef\u4f5c\u4e3a\u6cbb\u7597\u4e0a\u8ff0\u7f55\u89c1\u771f\u83cc\u7684\u4e3b\u8981\u836f\u7269\uff0c\u751a\u81f3\u53ef\u4f5c\u4e3a\u90e8\u5206\u7f55\u89c1\u771f\u83cc\uff0c\u5982\u6bdb\u9709\u7684\u4e00\u7ebf\u6cbb\u7597\u836f\u7269\uff0c\u503c\u5f97\u4e34\u5e8a\u4f18\u9009\u4f18\u7528\u3002\u5f80\u671f\u7cbe\u5f69\u56de\u987e<\/p>\n<p>1.\u62bd\u4e1d\u5265\u8327\uff0c\u5c42\u5c42\u5256\u6790\uff1a\u89e3\u8bfbWHO\u75c5\u539f\u4f53\u6e05\u5355\uff0c\u7406\u6e05\u771f\u83cc\u201c\u6863\u6848\u201d\uff01\uff08\u4e0a\uff09<\/p>\n<p>2.\u79d1\u5b66\u63a2\u79d8L-AmB\uff1a\u6ce8\u5c04\u7528\u4e24\u6027\u9709\u7d20B\u8102\u8d28\u4f53\u539f\u7814\u836f\u7269\u5373\u5c06\u4e0a\u5e02<\/p>\n<p>3.\u7978\u8d77\u8427\u5899\uff0c\u52b2\u654c\u8054\u624b\uff1aAD+IFD\uff0c\u4e34\u5e8a\u533b\u5e08\u5e94\u5982\u4f55\u7834\u9898\uff1f<\/p>\n<p>*\u672c\u6750\u6599\u7684\u76ee\u7684\u662f\u901a\u8fc7\u4ecb\u7ecd\u6709\u5173\u533b\u5b66\u548c\u79d1\u5b66\u4fe1\u606f\u548c\u8fdb\u5c55\uff0c\u63d0\u9ad8\u533b\u5b66\u4e13\u4e1a\u4eba\u58eb\u7684\u533b\u5b66\u77e5\u8bc6\u3002\u56e0\u6b64\uff0c\u672c\u6750\u6599\u4ec5\u4f9b\u533b\u5b66\u4e13\u4e1a\u4eba\u58eb\u4f7f\u7528\u3002\u672c\u6750\u6599\u5e76\u975e\u836f\u54c1\u5e7f\u544a\u3002\u8bfb\u8005\u4e0d\u5e94\u53c2\u8003\u6216\u4f9d\u8d56\u672c\u6750\u6599\u7684\u4efb\u4f55\u5185\u5bb9\uff0c\u505a\u51fa\u8d2d\u4e70\u6216\u4f7f\u7528\u4efb\u4f55\u836f\u54c1\u7684\u4efb\u4f55\u51b3\u5b9a\u3002<\/p>\n<p>\u83b7\u53d6\u66f4\u591a\u809d\u708e\u3001\u827e\u6ecb\u75c5\u3001\u6297\u771f\u83cc\u3001\u80bf\u7624\u9886\u57df\u6700\u65b0\u6587\u732e\u3001\u6307\u5357\u4e0e\u524d\u6cbf\u8d44\u8baf\uff0c\u4e0eAI\u533b\u5b66\u52a9\u624b\u201c\u6653\u667a\u201d\u4e92\u52a8\u6b22\u8fce\u5173\u6ce8\u201c\u5409\u667a\u533b\u201d<\/p>\n<p>\u626b\u7801\u5173\u6ce8\u201c\u5409\u667a\u533b\u201d<\/p>\n<p>\u957f\u6309\u8bc6\u522b\u4e8c\u7ef4\u7801<\/p>\n<p>\u83b7\u53d6\u66f4\u591a\u4fe1\u606f<\/p>\n<p>\u53c2\u8003\u6587\u732e\uff1a<\/p>\n<p>[1]WHO fungal priority pathogens list to guide research, development\uff0c and public health action[2]Fern\u00e1ndez-Cruz A, Semiglia MA, Guinea J, et al. A retrospective cohort of invasive fusariosis in the era of antimould prophylaxis.Med Mycol. 2020;58(3):300-309.[3]Hoenigl M, Salmanton-Garc\u00eda J, Walsh TJ, et al. Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology. Lancet Infect Dis. 2021 Feb 16:S1473-3099(20)30784-2.[4]Jenks JD, Reed SL, Seidel D, et al. Rare mould infections caused by Mucorales, Lomentospora prolificans and Fusarium, in San Diego, CA: the role of antifungal combination therapy.Int J Antimicrob Agents. 2018;52(5):706-712.[5]Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV. Washington (DC): Pan American Health Organization; April 2020.[6]Wheat LJ, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America.Clin Infect Dis. 2007;45(7):807-825.[7]Murray M, Hine P. Treating progressive disseminated histoplasmosis in people living with HIV.Cochrane Database Syst Rev. 2020;4(4):CD013594. Published 2020 Apr 28.[8]Prakash H, Chakrabarti A. Global Epidemiology of Mucormycosis.J Fungi (Basel). 2019;5(1):26. Published 2019 Mar 21.[9]Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium.Lancet Infect Dis. 2019;19(12):e405-e421.[10]Jeong W, Keighley C, Wolfe R, et al. Contemporary management and clinical outcomes of mucormycosis: A systematic review and meta-analysis of case reports.Int J Antimicrob Agents. 2019;53(5):589-597.[11]Masur H, Brooks JT, Benson CA, et al. Prevention and treatment of opportunistic infectionsin HIV-infected adults and adolescents: updated guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIVMedicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2014;58:1308-11.[12]\u4e2d\u534e\u533b\u5b66\u4f1a\u611f\u67d3\u75c5\u5b66\u5206\u4f1a\u827e\u6ecb\u75c5\u4e19\u578b\u809d\u708e\u5b66\u7ec4, \u4e2d\u56fd\u75be\u75c5\u9884\u9632\u63a7\u5236\u4e2d\u5fc3, \u674e\u592a\u751f. \u4e2d\u56fd\u827e\u6ecb\u75c5\u8bca\u7597\u6307\u5357(2021\u5e74\u7248)[J]. \u4e2d\u56fd\u827e\u6ecb\u75c5\u6027\u75c5, 2021, 27(11):20.[13]Sheng L, Shen Q, Zhou J. Efficacy of different antifungal drugs as initial treatment for patients with talaromycosis: A systematic review and meta-analysis.J Mycol Med. 2021;31(1):101108.<\/p>\n<p>\u6b64\u6587\u4ec5\u7528\u4e8e\u5411\u533b\u7597\u536b\u751f\u4e13\u4e1a\u4eba\u58eb\u63d0\u4f9b\u79d1\u5b66\u4fe1\u606f\uff0c\u4e0d\u4ee3\u8868\u5e73\u53f0\u7acb\u573a<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>*\u4ec5\u4f9b\u533b\u5b66\u4e13\u4e1a\u4eba\u58eb\u9605\u8bfb\u53c2\u8003 WHO\u4e8e2022\u5e74\u53d1\u5e03WHO FPPL\uff0c\u9ad8\u4f18\u5148\u7ea7\u548c\u4e2d &hellip; <a href=\"http:\/\/zydq.1006ss.com\/?p=31925\">\u7ee7\u7eed\u9605\u8bfb <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[70],"tags":[],"class_list":["post-31925","post","type-post","status-publish","format-standard","hentry","category-70"],"_links":{"self":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/31925","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31925"}],"version-history":[{"count":0,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/31925\/revisions"}],"wp:attachment":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31925"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31925"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31925"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}