摘要
目的探讨影响肺曲霉病患者伏立康唑血药浓度的因素,为伏立康唑安全有效使用提供依据。方法收集本院2020年1月至10月73例使用伏立康唑治疗的肺曲霉病患者病例资料,回顾性分析患者性别、年龄、肝功能指标、联合使用质子泵抑制剂或糖皮质激素对伏立康唑血药浓度的影响;比较伏立康唑血药浓度在有效血药浓度范围(0.50~5.00μg·mL^(-1)内及高于有效血药浓度上限患者的治疗效果和不良反应;考察伏立康唑对肝功能指标的影响。结果48例(66%)伏立康唑有效血药浓度范围内患者的治疗有效率为92%,与25例(34%)高于有效血药浓度上限患者的治疗有效率比较有显著差异(92%vs.64%,P<0.05),而不良反应发生率无显著差异(10%vs.16%,P>0.05)。年龄、性别、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、与质子泵抑制剂或糖皮质激素联合使用对患者伏立康唑血药浓度均无显著影响(P>0.05)。白蛋白水平低于正常下限(35 g·L^(-1))患者与白蛋白水平处于正常范围患者的伏立康唑血药浓度有显著差异[(4.64±2.31)μg·mL^(-1),vs.(3.23±1.99)μg·mL^(-1),P<0.05]。伏立康唑使用前后,患者的丙氨酸转氨酶、天冬氨酸转氨酶无显著变化(P>0.05),但总胆红素升高(P<0.05)。结论肺曲霉病患者的白蛋白水平显著影响其伏立康唑血药浓度。
AIM To explore the factors affecting the blood concentration of voriconazole in patients with pulmonary aspergillosis, and to provide evidence for the safe and effective use of voriconazole. METHODS The data of 73 patients with pulmonary aspergillosis treated with voriconazole from January 2020 to October 2020 in our hospital were collected.The effects of gender, age, liver function indexes, and combined use with proton pump inhibitors or glucocorticoids on the blood concentration of voriconazole were analyzed retrospectively, the therapeutic effects and adverse reactions of patients within the range of effective plasma concentration(0.50 to 5.00 μg·mL^(-1),)and above the upper limit were compared, and the effect of voriconazole on liver function indexes was studied. RESULTS The effective rate of 48 patients(66%) within the effective therapeutic concentration range of voriconazole was 92%, which was significantly different from that of 25patients(34%) above the upper limit of the range(92% vs. 64%, P < 0.05), and there was no significant difference in the incidence of adverse reactions(10% vs. 16%, P > 0.05). Age, gender, alanine aminotransferase, aspartate aminotransferase,total bilirubin, and combined use with proton pump inhibitors or glucocorticoids had no significant effect on the blood concentrations of voriconazole(P > 0.05). The plasma concentrations of voriconazole were significantly different between patients whose albumin level were lower than the lower limit of normal(35 g·L^(-1)) and patients whose albumin level were in the range of normal value((4.64±2.31)μg·mL^(-1) vs.(3.23±1.99)μg·mL^(-1),P < 0.05). There were no significant differences in the levels of alanine aminotransferase and aspartate aminotransferase before and after administration of voriconazole in these patients(P > 0.05), but the levels of total bilirubin increased(P < 0.05). CONCLUSION The albumin level of patient with pulmonary aspergillosis significantly affects their blood concentrations of voriconazole.
作者
王蓓蓓
许霞青
谭然
刘凡凡
张月丽
丁孝良
何勐
WANG Bei-bei;XU Xia-qing;TAN Ran;LIU Fan-fan;ZHANG Yue-li;DING Xiao-liang;HE Meng(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou HE-NAN 450007,China)
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2022年第4期228-233,共6页
Chinese Journal of New Drugs and Clinical Remedies
基金
河南省科技攻关项目(212102310121)
吴阶平医学基金会临床科研专项资助基金(320.6750.2021-02-57)。
关键词
伏立康唑
肺曲霉菌病
血药浓度
药物不良反应
voriconazole
pulmonary aspergillosis
plasma concentration
adverse drug reactions
