本文關(guān)鍵詞： 泊沙康唑 侵襲性肺部真菌感染 防治　出處：《中國(guó)藥房》2017年10期 　論文類(lèi)型：期刊論文

【摘要】：目的:為泊沙康唑防治侵襲性肺部真菌感染(IPFI)的機(jī)制研究與臨床應(yīng)用提供參考。方法:以"Posaconazole""Invasive pulmonary fungal infection""泊沙康唑""侵襲性肺部真菌感染"等為關(guān)鍵詞,組合查詢(xún)2001年1月-2015年10月在PubMed、Springer Link、Wiley Online Library、中國(guó)知網(wǎng)、萬(wàn)方、維普等數(shù)據(jù)庫(kù)中的相關(guān)文獻(xiàn),對(duì)泊沙康唑的藥品基本信息、藥動(dòng)學(xué)/藥效學(xué)特征、藥理作用及其作用機(jī)制和臨床研究進(jìn)行綜述。結(jié)果:共檢索到相關(guān)文獻(xiàn)3 478篇,其中有效文獻(xiàn)51篇。泊沙康唑?qū)儆谌蝾?lèi)抗真菌藥,其分子結(jié)構(gòu)的特點(diǎn)是在母環(huán)基礎(chǔ)上延伸出一條側(cè)鏈,具有呋喃環(huán),同時(shí)以氯代替了苯環(huán)上的氟,可抑制真菌細(xì)胞膜上合成麥角固醇的關(guān)鍵酶羊毛甾醇14α-去甲基化酶,從而發(fā)揮抗真菌作用;其具有耐藥性低、生物利用度高、肺內(nèi)濃度高等特點(diǎn)。泊沙康唑在小鼠肺內(nèi)的藥物濃度高,藥-時(shí)曲線(xiàn)下面積與最低抑菌濃度的比值可達(dá)440.91,對(duì)感染肺曲霉菌、毛霉菌的小鼠具有抗真菌效果。泊沙康唑?qū)PFI有一定效果,甚至可作為難治性IPFI的挽救治療用藥,但僅限于臨床觀(guān)察研究和個(gè)案報(bào)道,尚需更多高質(zhì)量的臨床隨機(jī)對(duì)照研究進(jìn)一步評(píng)估其防治IPFI的價(jià)值。
[Abstract]:Objective: to study the mechanism and clinical application of posaconazole in the prevention and treatment of invasive pulmonary fungal infection. Methods: "Posaconazole", "Invasive pulmonary fungal infection", "posaconazole", "invasive pulmonary fungal infection", etc. A combined query was made on the relevant documents in the database of PubMedus Springer Linkler Online Library, China Zhiwang, Wanfang and Weip from January 2001 to October 2015. The pharmacokinetic / pharmacodynamic characteristics of Posaconazole were analyzed, and the pharmacokinetic and pharmacodynamic characteristics of Posarconazole were analyzed. Results: a total of 3,478 related literatures were retrieved, of which 51 were effective. Posaconazole was a triazole antifungal drug. Its molecular structure is characterized by the extension of a side chain on the base of the mother ring, the existence of furan ring, and the substitution of chlorine for fluorine on the benzene ring, which can inhibit the synthesis of ergosterol on the cell membrane of fungi by the key enzyme, wool sterol 14 偽 -demethylase. It has the characteristics of low drug resistance, high bioavailability and high intrapulmonary concentration. The ratio of the area under the drug-time curve to the minimum inhibitory concentration was 440.91, which had antifungal effect on mice infected with Aspergillus pneumoniae and Mucor. Posaconazole had a certain effect on IPFI, and could even be used as a salvage therapy for refractory IPFI. But it is limited to clinical observation and case report. More high quality randomized controlled trials are needed to evaluate the value of IPFI prevention and treatment.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院呼吸內(nèi)科;
【分類(lèi)號(hào)】：R519

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本文編號(hào)：1524837