【作者】 颜苗； 蒋梦飞； 王峰； 肖轶雯； 徐萍； 张毕奎； 方平飞； 李焕德；

【机构】 中南大学湘雅二医院药学部； 中南大学临床药学研究所；

【摘要】 目的:总结我院伏立康唑血药浓度监测初期的情况,并对伏立康唑治疗药物监测结果进行评析。方法:采用全自动二维色谱系统测定患者伏立康唑的谷浓度,回顾性分析2014年5月到9月期间相关数据,并观察患者治疗期间的疗效和不良反应发生的情况。结果:共纳入9名患者,共监测浓度17例次,其伏立康唑的谷浓度中位数为5.93μg/m L(0.64~14.16μg/m L)。其中6人好转,2人治疗无效,1人死亡。共3人发生药物不良反应,其中2例为视觉障碍或幻觉,1例为转氨酶升高。该3名患者的血药浓度中位数为6.02μg/m L。结论:使用的伏立康唑测定方法抗干扰能力强、稳定、快速,给临床提供了准确的数据。伏立康唑浓度个体间差异大,可预测性差,相关科室严重侵袭性真菌病患者需监测其血药浓度,临床医生对于伏立康唑血药浓度监测的认识和掌握还不够,需要加大临床药师的干预。更多还原

【Abstract】 Objective:To uderstand our early monitoring voriconazole blood drug concentration,and voriconazole treatment drug monitoring results are elucidated.Methods:The trough concentrations were analyzed by HPLC joint FLC automatic secondary chromatography system method.The relevant data during the May 2014 to September 2014 were retrospectively analyzed,and the clinical effectiveness and adverse drug reactions during the pharmacotherapy period were observed.Results:A total of 9 patients were enrolled,and monitoring the concentration was 17 times and their trough concentrations of voriconazole were determined.The median concentration was 5.93 μg/m L(concentration range was 0.64 ~14.16 μg/m L).There were 6 patients completely or partial respondingto the anti-fungal therapy and 2failing to responding,1 dead.A number of 3 patients experienced voriconazole-related drug adverse reactions,and 2 of them were visual disturbances,and 1 was neurotoxicity.The median concentration of those experience adverse drug reactions was 6.02μg/ml。 Conclusion:High concentration variability was observed among patients,and need to monitor the blood drug concentration of patients who infect serious invasive fungal disease in related departments.Clinical doctors for understanding and mastering of voriconazole blood drug concentration monitoring is not enough,and need to increase the intervention of clinical pharmacists.更多还原