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| Retrospective clinical analysis of Voriconazole trough serum concentration monitoring in severe elderly patients |
| WANG Jia XU Bingfa QIN Kan |
| Department of pharmacy，the Third Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei 230061, China |
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Abstract Objective To explore the importance of monitoring Voriconazole trough serum concentration (Cmin) in severe elderly patients. Methods From January 2014 to December 2018, a retrospective analysis was used to analyze 43 cases who admitted to the Third Affiliated Hospital of Anhui Medical University with severe elderly patients. All patients were treated with Voriconazole, monitored and observed for Cmin. The effects of different factors on the blood drug Cmin of Voriconazole and the clinical effects and adverse reactions of plasma albumin (ALB) on voriconazole were compared. Results The Cmin was tested 78 times and 54 times (69.2%) of Cmin was 1.0~5.5 mg/L. ALB and AST were independent risk factors for Cmin, and ALB was negatively correlated with Cmin (r = -0.903, P = 0.0003). AST was positively correlated with serum concentration (r = 0.872, P = 0.0005). The effective rate of ALB<35 g/L was lower than that of ALB≥35 g/L, and the incidence of adverse reactions was higher than that of ALB≥35 g/L, the differences were statistically significant (P < 0.05). Conclusion There are many factors that affect the concentration of voriconazole in the severe elderly patients. It is particularly necessary to monitor the concentration of Voriconazole in the blood.
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[1] 朱慧芳，董亚琳，尤海生，等.伏立康唑的药动学/药效学及其药物监测[J].中国新药与临床杂志，2013，31（7）：367-372.
[2] Epaulard O，Leccia MT，Blanche S，et al. Phototoxicity and photocarcinogenesis associated with voriconazole [J]. Med Mal Infect，2011，41（12）：639-645.
[3] Ashbee HR，Barnes RA，Johnson EM，et al. Therapeutic drug monitoring（TDM）of antifungal agents：guidelines from the british society for medical mycology [J]. J Antimicrob Chemother，2014，69（5）：1162-1176.
[4] Luong ML，Al-Dabbagh M，Groll AH，et al. Utility of voriconazole therapeutic drug monitoring：a meta-analysis [J].J Antimicrob Chemother，2016，71（7）：1786-1799.
[5] 王晶晶，王茜，何瑾，等.伏立康唑血药浓度监测及其影响因素分析[J].中国医院药学杂志，2018，38（23）：2402-2405.
[6] 于思源，王芳，冯志平.伏立康唑谷浓度监测在侵袭性真菌感染治疗中的应用[J].今日药学，2017，27（5）：326-330.
[7] 徐丙发，陈思远，昂韦，等.低蛋白血症对危重症患者伏立康唑血药谷浓度的影响[J].中国新药杂志，2019，28（3）：308-313.
[8] 刘加涛，宋帅，苏涌，等.伏立康唑血药浓度监测及临床应用分析[J].安徽医学，2018，39（1）：74-77.
[9] 雷和平，周宏灏.伏立康唑的药代动力学及其与其他药物间的相互作用[J].实用医学杂志，2008，2（11）：2011-2013.
[10] Kempny A，Diller GP，Alonso-Gonzalez R，et al. Hypoalbuminaemia predicts outcome in adult patients with congenital heart disease [J]. Heart，2015，101（9）：699-705.
[11] 苏涌，杨春兰，黄燕，等.高效液相色谱法测定血浆中伏立康唑的浓度[J].安徽医药，2017，21（2）：244-247.
[12] 朱海燕，陈晶晶，李芙蓉，等.伏立康唑血药浓度与临床疗效和安全性之间的相关性[J].中国临床药学杂志，2017，26（6）：404-407.
[13] 梁培，郭晓芳.重症患者伏立康唑血药谷浓度监测分析[J].药物评价研究，2017，40（11）：1587-1592.
[14] Kittisakmontri K，Reungrongrat S，Lao-Araya M. Hypoalbuminaemia at admission predicts the poor outcomes in critically ill children [J]. Anaesthesiol Intensive Ther，2016，48（3）：158-161.
[15] 王童，李彩霞，顾彩红，等.伏立康唑血药浓度监测的临床应用[J].中国医院药学杂志，2017，37（21）：2151-2154.
[16] 谭哲君，莫文庆，万军，等.慢性阻塞性肺疾病急性加重期患者有创机械通气脱机困难相关危险因素分析[J].中国医药科学，2019，9（5）：213-215，226.
[17] 陈思远，徐丙发，范鲁雁，等.低蛋白血症对伏立康唑影响的研究进展[J].中国新药杂志，2017，26（21）：2546-2550.
[18] 姚鸣，代会，费爱华.伏立康唑用药方案及临床疗效监测的研究进展[J].临床误诊误治，2018，31（10）：102-105.
[19] 颜苗，王柠柠，李紫薇，等.伏立康唑血药浓度监测结果评析[J].药学实践杂志，2016，34（5）：421-423，446.
[20] Conil JM，Georges B，Lavit M，et al. A population pharmacokinetic approach to ceftazidime use in burn patients：Influence of glomerular filtration，gender and mechanical ventilation [J]. Br J Clin Pharmacol，2007，64（1）：27-35.
[21] 桑剑锋，马虎成，施晓雷，等.巴马小型猪85%肝切除术后急性肝功能衰竭模型的建立[J].中国实验动物学报，2017，25（2）：174-180.
[22] Parrillo JE，Parker MM，Natanson C，et al. Septic shock in humans.Advances in the understanding of pathogenesis，cardiovascular dysfunction，and therapy [J]. Ann Intern Med，1990，113（3）：227-242. |
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