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泊沙康唑预防侵袭性真菌感染的快速卫生技术评估
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                                       1
                                               1
                                                        1, 3 #
                            2
          栗玉杰    1, 2* ,马健桐 ,黄格日勒 ,张文静 ,郭 浩 (1.内蒙古自治区人民医院药学处,呼和浩特 010017;
          2.包头医学院药学院,内蒙古 包头 014040;3.内蒙古自治区基本药物监测与临床综合评价中心,呼和浩特
          010017)

          中图分类号  R978.5      文献标志码  A      文章编号  1001-0408(2026)10-1364-06
          DOI  10.6039/j.issn.1001-0408.2026.10.22


          摘   要  目的  评价泊沙康唑预防侵袭性真菌感染(IFIs)的有效性、安全性和经济性。方法  检索PubMed、Embase、中国知网、万
          方数据等中英文数据库,以及相关卫生技术评估(HTA)官方网站,收集泊沙康唑预防IFIs的系统评价(SR)/Meta分析、药物经济学
          研究及HTA报告。检索时限为建库至2025年11月1日。筛选文献、提取资料及评价文献质量后,对纳入研究的结果进行描述性
          分析。结果  共纳入45篇文献,其中SR/Meta分析17篇,药物经济学研究26篇,SR/Meta分析合并药物经济学研究1篇,HTA 1篇。
          有效性方面,泊沙康唑在降低IFIs发生率、侵袭性曲霉菌病发生率、全因死亡率及IFIs相关死亡率方面均显著优于其他抗真菌药
          物(如氟康唑、伊曲康唑等)(P<0.05)。安全性方面,泊沙康唑的总不良反应发生率显著低于其他抗真菌药物(P<0.05),严重不
          良反应、胃肠道不良反应、药物性肝损伤发生率,以及因药物不良反应退出率与其他抗真菌药物相当(P>0.05)。经济性方面,多
          数研究显示,泊沙康唑更具成本-效果优势。结论  泊沙康唑预防IFIs的有效性、安全性、经济性均较好。
          关键词  泊沙康唑;侵袭性真菌感染;预防;有效性;安全性;经济性


          Posaconazole for prevention of invasive fungal infections: a rapid health technology assessment
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                                 2
          LI Yujie ,MA Jiantong ,HUANG  Gerile ,ZHANG Wenjing ,GUO Hao (1.  Dept.  of  Pharmacy,  Inner
          Mongolia  People’s  Hospital,  Hohhot  010017,  China;2.  School  of  Pharmacy,  Baotou  Medical  College,  Inner
          Mongolia Baotou 014040, China;3. Inner Mongolia Autonomous Region Essential Drug Monitoring and Clinical
          Comprehensive Evaluation Center, Hohhot 010017, China)
          ABSTRACT    OBJECTIVE To evaluate the efficacy, safety, and cost-effectiveness of posaconazole for the prevention of invasive
          fungal  infections (IFIs).  METHODS  PubMed,  Embase,  CNKI,  Wanfang  data  and  other  Chinese  and  English  databases  were
          searched,  as  well  as  the  official  websites  of  related  health  technology  assessment (HTA).  Systematic  review (SR)/meta-analysis,
          pharmacoeconomic studies, and HTA reports of posaconazole for the prevention of IFIs were collected. The retrieval time limit was
          from the establishment of the database to November 1, 2025. After screening the literature, extracting the data, and evaluating the
          quality  of  the  literature,  the  results  of  the  included  studies  were  descriptively  analyzed.  RESULTS  A  total  of  45  studies  were
          included,  involving  17  SR/meta-analyses,  26  pharmacoeconomic  studies,  1  SR/meta-analysis  combined  with  a  pharmacoeconomic
          study,  and  1  HTA  report.  In  terms  of  effectiveness,  posaconazole  was  significantly  superior  to  other  antifungal  drugs (eg.,
          fluconazole,  itraconazole)  in  reducing  the  incidence  of  IFIs,  the  incidence  of  invasive  aspergillosis,  all-cause  mortality,  and  IFI-
          related mortality (P<0.05). In terms of safety, posaconazole was significantly superior to other antifungal drugs in the incidence of
          total  adverse  reactions (P<0.05),  but  there  was  no  significant  difference  in  the  incidence  of  serious  adverse  reactions,  the
          incidence  of  gastrointestinal  adverse  reactions,  drug-induced  liver  injury,  and  the  withdrawal  rate  due  to  adverse  drug  reactions
         (P>0.05). In terms of cost-effectiveness, most studies have shown that posaconazole possesses more cost-effectiveness advantages.
          CONCLUSIONS Posaconazole demonstrates favorable efficacy, safety, and cost-effectiveness in preventing IFIs.
          KEYWORDS     posaconazole; invasive fungal infections; prevention; efficacy; safety; cost-effectiveness



              侵袭性真菌感染(invasive fungal infections,IFIs)是       由真菌侵入组织或血液所致的感染性疾病,发病率和死
                                                                        [1]
                                                              亡率均较高 。全球每年约有650万例患者发生IFIs,直
              Δ 基金项目 内蒙古自治区公立医院科研联合基金科技项目(No.                 接相关死亡人数超过 250 万 。IFIs 主要致病菌为念珠
                                                                                      [2]
          2024GLLH0125)                                       菌、隐球菌和曲霉菌等 。IFIs 多发于异基因造血干细
                                                                                  [3]
             * 第一作者 硕 士 研 究 生 。 研 究 方 向 :临 床 药 学 。 E-mail:
                                                              胞 移 植(allogeneic  hematopoietic  stem  cell  transplanta‐
          13322492842@163.com
              # 通信作者 主任药师,博士。研究方向:临床药学、药物监测与临                 tion,allo-HSCT)、急性髓细胞性白血病(acute myelo‐
          床综合评价。E-mail:guohao19870323@yeah.net                cytic leukemia,AML)或骨髓增生异常综合征(myelodys‐

          · 1364 ·    China Pharmacy  2026 Vol. 37  No. 10                            中国药房  2026年第37卷第10期
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