【作者】 彭芳辰； 郑斌；

【Author】 PENG Fang-chen;ZHENG Bin;Department of Clinical Pharmacy in Shanxi Provincial People’s Hospital;

【机构】 山西省人民医院临床药学科；

【摘要】 目的:探讨使用伏立康唑的人群及合并用药对伏立康唑的血药浓度、不良反应及疗效的影响。方法:利用Pubmed、Embase、维普中国科技期刊数据库、中国知网、万方等数据库,检索1995—2014年有关伏立康唑的群体药代动力学、基因多态性以及与伏立康唑合并用药发生相互作用的文献报道,并进行分析汇总。结果:通过对文献进行分析,发现伏立康唑的血药浓度与患者自身的生理因素如年龄、性别、体重指数、肝功能有关,与患者的CYP2C19基因多态性有关,以及合用CYP450酶诱导剂和抑制剂的一些药物有关。结论:伏立康唑在体内代谢呈非线性药动学特性,其血药浓度受基因多态性以及多种药物相互作用的影响,不同人群疗效和不良反应存在显著个体间差异,因此,对CYP2C19基因型测定和伏立康唑的血药浓度的测定,实施个体化给药,可降低患者发生不良反应的风险,提高伏立康唑使用的有效性、安全性和经济性。更多还原

【Abstract】 Objective:To discuss the crowd who use the voriconazole and the influence of the drug combination which affected on the plasma concentration,adverse reactions,and the curative efficacy of voriconazole.Methods:The literature report of the voriconazole,such as the group pharmacokinetics and the gene polymorphism and the drug combination from 1995 to 2014 was researched by using PubMed,EMBASE,VIP Chinese science and technology periodical database,CNKI and Wanfang database,which were carried on the analysis and summary.Results:The plasma concentration of voriconazole related to the physiological factor of patients,such as age,gender,body mass index,liver function,and associated with the CYP2C19 gene polymorphism and related to the combination of some medicine of enzyme induction and inhibitors of CYP450 of the patient.Conclusion:The metabolism in vivo of voriconazole was a nonlinear pharmacokinetic characteristics,and the plasma concentration associated with the gene polymorphism and the multiple drug interactions,the effection of the different crowdes and the adverse reactions of voriconazole had significantly individual differences,therefore,the determination of CYP2C19 genotype and the plasma concentration benefited to the use of medicine of individual,and which can reduced the risk of adverse reactions and improved the effectiveness,safety and economy of voriconazole.更多还原