注射用两性霉素B胆固醇硫酸酯复合物致消化道出血1例分析

doi:10.19803/j.1672-8629.20250895

摘要/Abstract

摘要： 目的分析注射用两性霉素B胆固醇硫酸酯复合物（ABCD）治疗肺毛霉菌感染过程中发生消化道出血的关联性及其可能机制,为临床安全使用提供参考。方法分析1例老年侵袭性肺毛霉菌病患者使用ABCD后出现消化道出血的病例,并通过检索万方数据、中国知网、PubMed等数据库,收集国内外ABCD相关不良反应报道。采用国家药品不良反应监测中心的因果关系判断标准、诺氏（Naranjo’s）药品不良反应评分标准进行关联性评价。结果患者于ABCD抗真菌治疗第6天出现鲜红色血便,停药并给予止血治疗后症状缓解,未再复发。关联性评价显示,该消化道出血与ABCD之间的关联性为“很可能”。结论 ABCD虽可降低传统两性霉素B的肾毒性,但其致消化道出血的风险仍需警惕,尤其对于高龄、伴有多种基础疾病的患者。

关键词: 注射用两性霉素B胆固醇硫酸酯复合物, 肺毛霉菌病, 消化道出血, 老年患者, 药品不良反应

Abstract: Objective To study the association of gastrointestinal bleeding with amphotericin B cholesteryl sulfate complex for injection(ABCD) and potential mechanisms during the treatment of pulmonary mucormycosis in order to provide references for monitoring of clinical safety. Methods A retrospective analysis was conducted of an elderly patient with invasive pulmonary mucormycosis who had developed gastrointestinal bleeding after receiving ABCD. Such databases as Wanfang, CNKI, and PubMed were searched for reports on adverse reactions related to ABCD. Causality was evaluated using both the criteria stipulated by the National Adverse Drug Reaction Monitoring Center and the Naranjo Adverse Drug Reaction Probability Scale. Results The patient presented with fresh hematochezia on the sixth day of ABCD therapy. Symptoms were resolved after discontinuation of ABCD and hemostatic treatment, with no recurrence. Causality assessment indicated a “probable” association between ABCD and the gastrointestinal bleeding event. Conclusion Although ABCD can reduce the nephrotoxicity associated with conventional amphotericin B, its potential risk of inducing gastrointestinal bleeding warrants attention, particularly in elderly patients with multiple underlying conditions.

Key words: Amphotericin B cholesteryl sulfate complex for Injection, Pulmonary Mucormycosis, Gastrointestinal Bleeding, Elderly Patient, Adverse Drug Reaction

中图分类号:

杨亚静, 杨璐, 黄娜, 付裕豪, 沈颜红. 注射用两性霉素B胆固醇硫酸酯复合物致消化道出血1例分析[J]. 中国药物警戒, 2026, 23(7): 820-822.

Yang Yajing, Yang Lu, Huang Na, Fu Yuhao, Shen Yanhong. One case of gastrointestinal hemorrhage caused by amphotericin B cholesteryl sulfate complex for injection[J]. Chinese Journal of Pharmacovigilance, 2026, 23(7): 820-822.

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