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目的评估伊曲康唑注射液治疗侵袭性真菌感染的肝脏安全性。方法回顾性分析上海华山医院在2004年6月至2005年12月期间,59例住院患者应用伊曲康唑注射液治疗侵袭性真菌感染的肝脏基础疾病、肝功能变化以及肝损害与伊曲康唑注射液的相关性。结果59例患者感染的侵袭性致病真菌主要为曲霉、新生隐球菌、念珠菌、马尼菲青霉、小型无绿藻,感染部位主要为肺脏、颅脑、心脏以及血流等。20例患者在应用伊曲康唑治疗中出现肝功能异常,其中治疗前有肝功能异常患者更易发生进一步肝损害(P=0．001)。然而,相关性分析显示,有2例患者肝功能异常与伊曲康唑很可能有关,为轻度损害;1例可能有关,轻度损害;1例可能无关,为重度损害;16例与伊曲康唑无关,而与肝脏基础疾病、抗结核或两性霉素B等药物有关。结论伊曲康唑注射液具有较好的肝脏安全性,但对于有肝病基础患者或联合应用其他损肝药物时,应积极保肝治疗,并动态随访肝功能。
Objective To evaluate the safety of itraconazole injection in the treatment of liver in patients with invasive fungal infection. Methods A retrospective analysis of Shanghai Huashan Hospital during June 2004 to December 2005, 59 cases of hospitalized patients with itraconazole injection in the treatment of liver disease foundation invasive fungal infections, liver function and liver damage and itraconazole Correlation of azole injection. Results The main pathogenic fungi in 59 patients were Aspergillus, Cryptococcus neoformans, Candida albicans, Penicillium mannii and Microcystis minor. The main infection sites were lung, brain, heart and blood flow. Twenty patients had abnormal liver function during treatment with itraconazole, and further liver damage was more likely to occur in patients with pre-treatment liver dysfunction (P = 0.001). However, the correlation analysis showed that two cases of liver dysfunction and itraconazole may be related to mild damage; one case may be related to mild damage; one case may not be related to severe damage; 16 cases and Iraq Itraconazole has nothing to do with the underlying liver disease, anti-TB or amphotericin B and other drugs. Conclusion Itraconazole injection has good liver safety, but for patients with liver disease or other combination of liver damage drugs, should be actively protected liver and dynamic follow-up of liver function.