目的观察三唑类联合棘白菌素类抗真菌药物对曲霉的体外抑菌活性。方法采用EUCAST方法检测62株曲霉对伏立康唑(VRC)、伊曲康唑(ICZ)、卡泊芬净(CAS)和米卡芬净(MICA)的体外敏感性,观察各药物的100%被抑菌最小浓度(MIC-0),VRC和ICZ的50%被抑菌最小浓度(MIC-2),以及CAS和MICA的最低有效浓度(MEC)。分别以MIC-0和MIC-2与MEC为观察终点,采用棋盘法检测VRC或ICZ联合CAS或MICA的分数抑菌浓度(FIC)。结果以MIC-0为终点的FIC,有2株烟曲霉对ICZ联合CAS或MICA表现为无关作用,其他烟曲霉株以及黄曲霉株和黑曲霉株对VRC或ICZ联合CAS或MICA均表现为协同作用;以MIC-2与MEC为终点的FIC,对VRC和CAS、VRC和MICA、ICZ和CAS以及ICZ和MICA的联合表现为协同作用的烟曲霉(n=35)分别有16株、21株、11株和14株,黄曲霉(n=20)分别有9株、13株、9株和11株,黑曲霉(n=7)分别有0株、2株、1株和1株。结论不同的观察终点,两药联合的敏感性结果差异较大,体外无法判断三唑类联合棘白菌素类抗真菌药物对曲霉抑菌活性的影响,需要在侵袭性曲霉病动物实验中进一步证实。 Objective To observe the antibacterial activity of triazole combined with echinocandin antifungal agents against Aspergillus in vitro. Methods EUCAST was used to detect the in vitro susceptibility of 62 Aspergillus to VRC, ICZ, CAS and MICA, Minimum MIC (MIC-0), 50% Minimum Inhibitory Concentration (MIC-2) of VRC and ICZ, and Minimum Effective Concentration (MEC) of CAS and MICA. The MICs of MIC-0, MIC-2 and MEC were observed respectively. Fractional inhibitory concentration (FIC) of VRC or ICZ combined with CAS or MICA was detected by the checkerboard method. Results FIC with MIC-0 as the end point showed that 2 Aspergillus fumigatus had no effect on ICZ combined with CAS or MICA. Other Aspergillus fumigatus and Aspergillus flavus and Aspergillus niger strains showed synergistic effect on VRC or ICZ combined with CAS or MICA ; FIC ending with MIC-2 and MEC, 16 strains of Aspergillus fumigatus (n = 35) which had a synergistic effect on the combination of VRC and CAS, VRC and MICA, ICZ and CAS and ICZ and MICA respectively, and 21 , 11 strains and 14 strains respectively, and 9 strains, 13 strains, 9 strains and 11 strains of Aspergillus flavus (n = 20), 0, 2, 1 and 1 respectively. Conclusions Different end points of observation lead to great differences in the sensitivity of the combination of the two drugs. In vitro, it is not possible to judge the effect of the triazole and the echinocandin antifungal drugs on the antibacterial activity of Aspergillus. Therefore, it is necessary to further study the animal experiments of invasive Aspergillosis Confirmed.