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

关键词:  侵袭性真菌感染  德尔菲法  临床综合评价  两性霉素B

Key words:  invasive fungal disease  delphi method  clinical comprehensive evaluation  amphotericin B

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，并以传统两性霉素B（AmB）、两性霉素B脂质体（L- AmB）和两性霉素B胆固醇硫酸酯复合物（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AmB在治疗IFD的临床综合价值得分分别为73.50分、70.50分和49.50分。结论 实证研究表明，ABCD的临床综合价值较L- AmB和AmB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 traditional Amphotericin B (AmB), liposomal Amphotericin B (L-AmB), and Amphotericin B cholesterol sulfate complex (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 AmB were 73.50, 70.50, and 49.50, respectively). CONCLUSION Empirical research indicated that the clinical comprehensive value score of ABCD was higher than that of L-AmB and AmB. 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.