两性霉素B治疗侵袭性真菌病的临床综合评价

陈丽萍; 赵楚欣; 徐志浩; 余悦; 宣建伟

doi:10.13748/j.cnki.issn1007-7693.20243343

两性霉素B治疗侵袭性真菌病的临床综合评价

Comprehensive Clinical Evaluation of Amphotericin B in the Treatment of Invasive Fungal Disease

摘要

摘要:
目的探索建立侵袭性真菌感染治疗药品临床综合评价指标体系，并展开实证研究，以期为临床合理用药提供评价方法学参考。
方法基于文献综述和相关指南，采用德尔菲法构建侵袭性真菌感染治疗药品的临床综合评价指标体系及评价细则，并以两性霉素B脱氧胆酸盐(amphotericin B deoxycholate，AmBd)、两性霉素B脂质体(liposomal amphotericin B，L-AmB)和两性霉素B胆固醇硫酸酯复合物(amphotericin B colloidal dispersion，ABCD)为例展开实证研究。
结果经专家论证，最终确定了6个一级指标和13个二级指标、相应权重及量化评分细则，根据评价证据进行打分，得到ABCD、L-AmB和AmBd在治疗侵袭性真菌病的临床综合价值得分分别为73.50、70.50和49.50分。
结论实证研究表明，ABCD的临床综合价值较L-AmB和AmBd更高。侵袭性真菌感染治疗药品临床综合评价指标体系可为临床合理用药提供参考依据。

Abstract:
OBJECTIVE To explore the establishment of a clinical comprehensive evaluation index system for the treatment of invasive fungal infections and to conduct empirical research, aiming to provide methodological references for rational clinical use in hospitals.
METHODS Based on literature review and relevant guidelines, the Delphi method was used to construct a clinical comprehensive evaluation index system and evaluation criteria for the treatment of invasive fungal infections. Empirical research was conducted using amphotericin B deoxycholate(AmBd), liposomal amphotericin B(L-AmB), and amphotericin B colloidal dispersion(ABCD) as examples.
RESULTS After expert validation, six primary indicators and thirteen secondary indicators were finalized along with their corresponding weights and quantitative scoring. According to the collected evidence, the clinical comprehensive value scores of ABCD, L-AmB and AmBd were 73.50, 70.50 and 49.50, respectively.
CONCLUSION Empirical research indicates that the clinical comprehensive value score of ABCD is higher than that of L-AmB and AmBd. The clinical comprehensive evaluation index system and evaluation criteria for the treatment of invasive fungal infections can provide reference for rational drug use in clinical practice.

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