伏立康唑血药浓度与临床疗效及安全性相关性的研究进展  

Advances on the relationships between the concentration of voriconazole and clinical response and its safety

作　　者：史长城[1,2,3] 李晴宇[1,3] 林能明[1,2,3] SHI Chang-cheng LI Qing-yu LIN Neng-ming(Hangzhou First People＇s Hospital, Hangzhou, Zhejiang 310006, China)

机构地区：[1]杭州市第一人民医院药剂科,浙江杭州310006 [2]杭州市第一人民医院转化医学研究中心临床药理研究室,浙江杭州310006 [3]南京医科大学附属杭州医院临床药学研究室,浙江杭州310006

出　　处：《中华医院感染学杂志》2017年第4期957-960,共4页Chinese Journal of Nosocomiology

基　　金：浙江省卫生高层次创新人才培养基金(浙卫发[2010]-190);杭州市一类医学重点学科经费资助(杭卫计办[2014]-13)

摘　　要：伏立康唑(VRC)血药浓度个体差异较大,临床通常需要监测血药浓度以提高其临床疗效和安全性。VRC最佳的血药浓度范围目前尚存争议,因此笔者对近年来VRC血药浓度与其临床疗效及安全性的相关性文献进行了综述。有效性方面,VRC血药浓度较低通常治疗失败率较高,但VRC预防性应用的相关性文献报道较少。安全性方面,VRC血药浓度较高通常容易出现神经毒性,通过降低血药浓度可以减少神经毒性;肝脏毒性与血药浓度相关,但在血药浓度较低时仍可出现。优化VRC血药浓度目标范围仍亟待更多研究。The concentration of voriconazole（VRC）is highly variable.Therapeutic drug monitoring is required to improve the clinical response and safety of VRC.The optimum concentration of VRC for clinical response and safety is controversial so far.Therefore,we reviewed the related literatures of the relationships between VRC blood concentration,efficacy and safety.Low concentration of VRC was frequently associated with a higher incidence of treatment failure,but the literatures of VRC prophylactic application was limited.Neurotoxicity usually appeared at high VRC concentration and could be decreased by lowing concentration of VRC.However,hepatotoxicity appeared to be associated with VRC blood concentration,but was still prevalent at low concentration.Further research may need to optimize the therapeutic range of VRC blood concentration.

关 键 词：伏立康唑 有效性 安全性 治疗药物浓度监测 

分 类 号：R978.5[医药卫生—药品]