新型冠状病毒肺炎治疗药物监测研究进展  

Progress in Therapeutic Drug Monitoring of 2019 Novel Coronavirus Pneumonia

作　　者：邢亚茹 李迎迎[2] 尹林[1] 石慧春 卢洪洲[1] 张丽军[1] XING Ya-ru;LI Ying-ying;YIN Lin;SHI Hui-chun;LU Hong-zhou;ZHANG Li-jun(Shanghai Public Health Clinical Center,Shanghai 201508,China;Guilin Medical University,Guilin 541004,Guangxi,China)

机构地区：[1]上海市公共卫生临床中心,中国上海201508 [2]桂林医学院,中国广西桂林541004

出　　处：《生命科学研究》2020年第3期173-179,共7页Life Science Research

基　　金：十三五重大新药创制——抗艾滋病病毒新药临床评价技术平台建设项目(2017ZX09304027);浙江大学新型冠状病毒肺炎(COVID-19)应急科研专项资金资助项目。

摘　　要：新型冠状病毒肺炎(简称“新冠肺炎”)在全球持续蔓延,其治疗用药均为老药新用。但这些药物在新的适应症中的药代动力学参数缺乏,且很多患者需要使用血透和人工肺等可能影响药物浓度的治疗手段,因此急需对患者用药进行治疗药物监测(therapeutic drug monitoring,TDM),以提高临床用药的有效性,并降低其毒副作用。本研究对新冠肺炎患者使用的羟基氯喹、替考拉宁、阿比朵尔、克立芝(洛匹那韦/利托那韦,LPV/RTV)和万古霉素的治疗药物监测进行综述,包括各药在老适应症患者中的TDM研究进展、药物浓度检测的方法(主要是液相色谱串联质谱法)、血药浓度治疗窗以及这些药物在新冠肺炎患者中的TDM研究进展,以期为新冠肺炎TDM研究提供方法学的支持,为患者个体化用药提供理论依据。The corona virus disease 2019(COVID-19)is spreading all over the world.The current clinical treatment is dependent on old drugs.However,the pharmacokinetic parameters of all these drugs in COVID-19 treatment are very limited,and furthermore,there are some therapeutic factors(such as hemodialysis,and extracorporeal membrane oxygenation(ECMO))affecting pharmacokinetic parameters.It is necessary to perform therapeutic drug monitoring(TDM)to improve clinical efficacy and decrease drug adverse reactions.In this work,we reviewed the TDM development of hydroxychloroquine,teicoplanin,arbidol,Klitsch(lopinavir/ritonavir,LPV/RTV),and vancomycin used in COVID-19 patients,including the TDM progress of these drugs in other diseases,concentration detection methods(mainly liquid chromatograph tandem mass spectrometry),therapeutic window range,and the TDM development of these drugs in COVID-19 patients.This review may provide methodological support for TDM research,and provide theoretical basis for individualized medication of COVID-19.

关 键 词：新型冠状病毒肺炎(COVID-19) 治疗药物监测(TDM) 羟基氯喹 替考拉宁 液相色谱串联质谱法(LC-MS/MS) 

分 类 号：Q5-33[生物学—生物化学] R183[医药卫生—流行病学]