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Abstract：
Invasive fungus infections caused by aspergillus spp. occur most frequently in immunocompromised patients. A high infection-associated death rate of up to and over 50% is attributed even today to these fungi. The disease in humans is caused mainly by Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger. Other species, for example, Aspergillus terreus or Aspergillus nidulans are quantitatively less prevalent. Evidence based treatment of invasive aspergillosis has become safer and more effective within the last ten years through the introduction of the new azoles and the echinocandines. Voriconazole has become the medication of choice for initial therapy. The efficacy of voriconazole is well documented, to include the treatment of disseminated infections of the central nervous system. Amphotericin B-desoxycholate is associated with definite side-effects in intravenous therapy. On the grounds of its substantial toxicity, the North American Infectious Disease Society\'s (IDSA) Guidelines of 2008 recommend amphotericin B-desoxycholate for regions with restricted resources only, which could be the case in underdeveloped countries. Liposomal amphotericin B in the daily standard dose of 3 mg/kg offers a rate of response similar to the one with voriconazole in the first-line treatment of invasive aspergillosis. However, a direct comparison with voriconazole on the basis of randomized studies is not available. As a secondary therapeutic treatment, in case of failure or intolerance of the primary treatment, caspofungin, micafungin and posaconazole have recently been under study. Both the echinocandines and posaconazole have proven effective in daily clinical practise. In refractory cases of invasive aspergillosis a combination therapy has been employed clinically. The results of prospective comparative controlled studies on combination therapy versus monotherapy will not be available until after 2010.
摘要：
曲霉菌引起的侵袭性真菌感染。最常见于免疫功能低下的患者。甚至在今天,高达和超过50%的与感染相关的高死亡率归因于这些真菌。人类的疾病主要由烟曲霉引起，黄曲霉和黑曲霉。其他物种,例如,土曲霉或构巢曲霉在数量上不那么普遍。在过去的十年中，通过引入新的唑类药物和棘毒菌素，侵袭性曲霉病的循证治疗变得更安全，更有效。伏立康唑已成为初始治疗的首选药物。伏立康唑的疗效有据可查,包括治疗中枢神经系统的播散性感染。两性霉素B-脱氧胆酸盐在静脉治疗中与明确的副作用相关。基于它的巨大毒性，2008年北美传染病学会（IDSA）指南推荐两性霉素B-脱氧胆酸盐只适用于资源有限的地区，这可能是在不发达国家的情况。每日标准剂量为3mg/kg的脂质体两性霉素B在侵袭性曲霉病的一线治疗中的反应率与伏立康唑相似。然而,无法在随机研究的基础上与伏立康唑进行直接比较.作为二级治疗，如果主要治疗失败或不耐受，卡波芬金,米卡芬净和泊沙康唑最近一直在研究中。在日常临床实践中，棘白菌素和泊沙康唑都被证明是有效的。在难治性侵袭性曲霉病病例中，临床上已采用联合疗法。关于联合治疗与单一治疗的前瞻性比较对照研究的结果要到2010年后才能获得。
