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引用本文:蒋婷婷,翁翠莲,黄毅婷,陈美娇,黄旭慧.伏立康唑潜在中毒浓度的危险因素研究[J].中国现代应用药学,2022,39(4):524-528.
JIANG Tingting,WENG Cuilian,HUANG Yiting,CHEN Meijiao,HUANG Xuhui.Study on the Risk Factors of Potentially Toxic Concentration of Voriconazole[J].Chin J Mod Appl Pharm(中国现代应用药学),2022,39(4):524-528.
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伏立康唑潜在中毒浓度的危险因素研究
蒋婷婷1, 翁翠莲2, 黄毅婷1, 陈美娇1, 黄旭慧1
1.福建省立金山医院药学部, 福州 350028;2.福建省立金山医院重症医学科, 福州 350028
摘要:
目的 探讨伏立康唑潜在中毒浓度的相关危险因素,以筛查其高危人群。方法 对2017年1月-2019年12月使用伏立康唑且监测其血药浓度的患者进行回顾性分析,将患者根据血药浓度值分为Cmin ≤ 5.5 μg·mL-1组和Cmin> 5.5 μg·mL-1组,采用单因素和Logistic多因素分析伏立康唑潜在中毒浓度的危险因素,应用ROC曲线对数值型危险因素作为预测因子的特异性、敏感性及临界值进行分析。结果 共纳入患者78例,其中33.33%(26例)患者的伏立康唑谷浓度>5.5 μg·mL-1。单因素分析表明,伏立康唑潜在中毒浓度(>5.5 mg·L-1)与性别、低蛋白血症、总胆红素和C反应蛋白(C-reactive protein,CRP)显著相关;多因素分析表明,高CRP是伏立康唑潜在中毒浓度的独立危险因素。ROC曲线分析显示,CRP>53 mg·L-1的患者是发生伏立康唑潜在中毒浓度的高危人群。结论 对CRP>53 mg·L-1的高危人群应密切监测伏立康唑血药浓度,以避免发生不良反应事件。
关键词:  伏立康唑  潜在中毒浓度  危险因素
DOI:10.13748/j.cnki.issn1007-7693.2022.04.014
分类号:R969.3
基金项目:福建省卫生计生青年科研课题(2018-1-29)
Study on the Risk Factors of Potentially Toxic Concentration of Voriconazole
JIANG Tingting1, WENG Cuilian2, HUANG Yiting1, CHEN Meijiao1, HUANG Xuhui1
1.Fujian Provincial Hospital Jinshan Branch, Department of Pharmacy, Fuzhou 350028, China;2.Fujian Provincial Hospital Jinshan Branch, Department of Critical Care Medicine, Fuzhou 350028, China
Abstract:
OBJECTIVE To explore the risk factors associated with potentially toxic concentrations of voriconazole in patients in order to screen the high-risk populations.METHODS Retrospective analysis was performed on patients who used voriconazole and monitored their blood concentrations from January 2017 to December 2019, and the patients were divided into Cmin ≤ 5.5 μg·mL-1 group and Cmin>5.5 μg·mL-1 group according to the blood concentration value. The risk factors for the potentially toxic concentrations of voriconazole were analyzed by univariate and Logistic multivariate analysis. Using ROC curve to analyze the specificity, sensitivity and critical value of numerical risk factors as predictors. RESULTS Seventy eight patients were included, of which 33.33%(26 patients) had a voriconazole trough concentration>5.5 μg·mL-1. Univariate analysis showed that the potentially toxic concentrations of voriconazole(>5.5 μg·mL-1) were significantly associated with gender, hypoproteinemia, TBIL and C-reactive protein(CRP). Multivariate analysis showed that high CRP level was independent risk factor for potentially toxic concentrations of voriconazole. ROC curve analysis indicated that patients with CRP>53 mg·L-1were at high risk of the occurrence of potential toxic concentrations of voriconazole.CONCLUSION For high-risk groups with CRP>53 mg·L-1, the blood concentration of voriconazole should be closely monitored to avoid adverse events.
Key words:  voriconazole  potentially toxic concentration  risk factor
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