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C_(min)≤5.5μg·mL^(-1)组和C_(min)>5.5μg·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>5.5μg·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。
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 C_(min)≤5.5μg·mL^(-1)group and C_(min)>5.5μg·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>5.5μg·mL^(-1).Univariate analysis showed that the potentially toxic concentrations of voriconazole(>5.5μg·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^(-1)were 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.
作者
蒋婷婷
翁翠莲
黄毅婷
陈美娇
黄旭慧
JIANG Tingting;WENG Cuilian;HUANG Yiting;CHEN Meijiao;HUANG Xuhui(Fujian Provincial Hospital Jinshan Branch,Department of Pharmacy,Fuzhou 350028,China;Fujian Provincial Hospital Jinshan Branch,Department of Critical Care Medicine,Fuzhou 350028,China)
出处
《中国现代应用药学》
CAS
CSCD
北大核心
2022年第4期524-528,共5页
Chinese Journal of Modern Applied Pharmacy
基金
福建省卫生计生青年科研课题(2018-1-29)
关键词
伏立康唑
潜在中毒浓度
危险因素
voriconazole
potentially toxic concentration
risk factor
