摘要
目的优化伏立康唑在重症监护室(ICU)的临床应用。方法选取某三甲医院2018年1月至2020年1月静脉使用伏立康唑并进行血药浓度监测的ICU患者116例,收集患者的伏立康唑谷浓度、年龄、性别、给药剂量、总蛋白(TP)、白蛋白(Alb)、肝功能、肾功能、联合用药、辅助治疗等信息,共监测267例次,采用单因素与多因素结合效应模型分析伏立康唑谷浓度的影响因素。结果伏立康唑稳态谷浓度为0.34~14.77 mg/L,约76%在有效治疗范围内;单因素分析结果显示,年龄、性别、每日每千克体质量剂量、丙氨酸氨基转移酶、天冬氨酸氨基转移酶(AST)、TP及Alb水平均对谷浓度有显著影响;多因素混合效应模型分析结果显示,每日每千克体质量剂量、AST及Alb水平均为独立危险因素。结论ICU患者伏立康唑谷浓度变异大,影响因素较多,有必要进行治疗药物监测。
Objective To optimize the clinical application of voriconazole in the intensive care unit(ICU).Methods From January 2018 to January 2020,116 ICU patients who were treated with voriconazole intravenously and had the plasma concentration monitoring were selected,the voriconazole trough concentration,age,gender,dose,total protein(TP),albumin(Alb),liver function,renal function,combination therapy,adjuvant therapy and other information of patients were collected.A total of 267 times of plasma concentration monitoring were carried out.Single factor and Multivariate mixed effect model were used to analyze the influencing factors of voriconazole trough concentration.Results The steady-state voriconazole trough concentration was 0.34-14.77 mg/L,about 76%of which was within the effective therapeutic concentration.Univariate analysis showed that age,gender,daily dose per kilogram of body weight,alanine aminotransferase(ALT),aspartate aminotransferase(AST),TP and Alb levels had significant effects on the voriconazde trough concentration.Multivariate mixed effect model analysis showed that daily dose per kilogram of body weight and AST,Alb levels were independent risk factors.Conclusion Voriconazole trough concentration in ICU patients varies greatly,and there are many influencing factors,it is necessary to monitor the voriconazole concentration.
作者
朱芮芮
刘晓青
韩栋
李强
刘学松
陈文瑛
ZHU Ruirui;LIU Xiaoqing;HAN Dong;LI Qiang;LIU Xuesong;CHEN Wenying(The Third Affiliated Hospital of Southern Medical University,Guangzhou,Guangdong,China 510631;The First Affiliated Hospital of Guangzhou Medical University,Ghuangzhou,Guangdong,China 510030)
出处
《中国药业》
CAS
2021年第10期89-92,共4页
China Pharmaceuticals
基金
广东省医学科学技术研究基金[C2020070]
广州医科大学附属第一医院2019年度成果培育和临床转化应用培育类项目[ZH201907]。
关键词
伏立康唑
血药浓度监测
谷浓度
影响因素
重症监护室
voriconazole
monitoring of plasma concentration
trough concentration
influencing factors
intensive care unit
