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中国临床药理学与治疗学 ›› 2021, Vol. 26 ›› Issue (6): 640-646.doi: 10.12092/j.issn.1009-2501.2021.06.006

• 临床药理学 • 上一篇    下一篇

造血干细胞移植患者伏立康唑稳态谷浓度监测及其影响因素分析

彭敏1,黄攀豪2,邓银华1,刘文1,李威3,于珍2,夏青2,谢悦良2   

  1. 1湖南省人民医院 药学部,长沙 410005,湖南;2中南大学湘雅三医院 药学部,长沙 410005,湖南;3湖南省肿瘤医院 药学部,长沙 410005,湖南

  • 收稿日期:2021-01-11 修回日期:2021-05-13 出版日期:2021-06-26 发布日期:2021-07-06
  • 通讯作者: 谢悦良,女,博士,副主任药师,研究方向:临床药学与药代动力学。 Tel: 13487579140 E-mail: xyl152@163.com
  • 作者简介:彭敏,女,硕士,主管药师,研究方向:医院药学与药代动力学。 Tel: 15874106492 E-mail: 541510915@qq.com
  • 基金资助:
    湖南省卫生厅项目(B20180896);湖南省人民医院仁术基金项目(RS201915)

Analysis of influence factors of voriconazole trough concentration in patients with hematopoietic stem cell transplantation

PENG Min 1, HUANG Panhao 2, DENG Yinhua 1, LIU Wen 1, LI Wei 3, YU Zhen 2, XIA Qing 2, XIE Yueliang 2   

  1. 1 Hunan Provincial People's Hospital, Changsha 410005, Hunan, China; 2 Department of Pharmacy, Third Xiangya Hospital, Central South University Pharmacy, Changsha 410005, Hunan, China; 3 Hunan Cancer Hospital, Changsha 410005, Hunan, China
  • Received:2021-01-11 Revised:2021-05-13 Online:2021-06-26 Published:2021-07-06

摘要: 目的:研究伏立康唑在造血干细胞移植患者中的稳态谷浓度(Cmin)分布特征,探讨影响其稳态Cmin的因素。方法:回顾性分析72例使用伏立康唑的患者,测定226份血清标本中伏立康唑稳态Cmin,收集患者的临床资料。采用SPSS22.0软件分析伏立康唑稳态Cmin与协变量(性别,年龄,体质量,中性粒细胞计数,C反应蛋白,白蛋白,肝肾功能,药物相互作用等)的相关性。结果:伏立康唑Cmin的平均值是(1.84±0.09)μg/mL,在有效血药浓度范围内占84.5%。年龄、白蛋白、总胆红素和C反应蛋白对伏立康唑血药浓度有显著性影响。联用激素并未降低患者的伏立康唑Cmin。伏立康唑用药前后谷草转氨酶、谷丙转氨酶、直接胆红素有显著性差异。 结论:影响伏立康唑血药浓度因素较多,应加强血药浓度监测,提高治疗的有效性,减少药物毒副反应。

关键词: 伏立康唑, 造血干细胞移植, 治疗药物监测, 影响因素

Abstract: AIM: To study the distribution characteristics of steady-state trough concentration (Cmin) of voriconazole in Chinese patients with hematopoietic stem cell transplantation, and to explore the factors that affect its steady-state Cmin. METHODS: A retrospective analysis of 72 patients using voriconazole, the steady-state Cmin of voriconazole in 226 serum samples were determined, and clinical data of the patients were collected. SPSS 22.0 software was used to analyze the correlation between voriconazole steady-state Cmin and covariates (gender, age, weight, white blood cell count, neutrophil count, C-reactive protein, albumin, liver and kidney function, drug interactions, etc.). RESULTS: The average Cmin of voriconazole was (1.84±0.09) μg/mL, which accounted for 84.5% of the effective blood concentration range. Age, albumin, total bilirubin, and CRP had a significant effect on the blood concentration of voriconazole. Combined use of hormones did not reduce the patient's voriconazole Cmin. It was found that there were significant differences in aminotransferase, alanine aminotransferase and direct bilirubin before and after voriconazole administration. CONCLUSION: There are many factors that affect the blood concentration of voriconazole. Blood concentration monitoring should be enhanced to improve the effectiveness of voriconazole treatment and reduce side effects of drugs.

Key words: voriconazole, hematopoietic stem cell transplantation, therapeutic drug monitoring, influencing factors

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