1630例患者伏立康唑血药浓度监测结果的分析  

Analysis of plasma voriconazole concentration monitoring results in 1630 patients

作　　者：陈瑶[1] 陈思宇 白杨娟[3] 安云飞[3] 戴鑫华 邹远高[3] CHEN Yao;CHEN Siyu;BAI Yangjuan;AN Yunfei;DAI Xinhua;ZOU Yuangao(Kidney Transplant Center,West China Hospital,Sichuan University,Chengdu,Sichuan,610041 P.R.China;West China Hospital(Airport),Sichuan University,Chengdu,Sichuan,610200 P.R.China;Department of Medical Laboratory,West China Hospital,Sichuan University,Chengdu,Sichuan,610041 P.R.China)

机构地区：[1]四川大学华西医院肾移植中心,四川成都610041 [2]四川大学华西空港医院,四川成都610200 [3]四川大学华西医院实验医学科,四川成都610041

出　　处：《华西药学杂志》2024年第6期685-688,共4页West China Journal of Pharmaceutical Sciences

摘　　要：目的探究多种因素对伏立康唑(VRC)血药浓度的影响,为合理用药提供参考。方法采用UPLC-MS/MS法检测患者血浆中VRC的浓度,以赛庚啶为内标,使用WatersBEHC_(18)色谱柱,以0.1%甲酸-乙腈(60:40)为流动相洗脱。质谱采用电喷雾离子,多反应监测扫描,VRC和赛庚啶的定量分析离子对分别为m/z350.4→127.1和m/z288.4→96.1,采用正离子模式对1630例患者进行治疗性药物浓度监测,并对结果进行回顾性分析。结果对1630例住院患者共计3758例次VRC血药浓度监测结果的分析表明:平均血药谷浓度为3.47±4.01mg·L^(-1),存在较大的个体间差异,其中2605例次(69.32%)的血药浓度在推荐浓度(0.5~5.0mg·L^(-1))内。不同年龄组的VRC血药浓度具有统计学差异,与患者年龄呈显著的正相关性,随患者年龄增加,药物浓度逐渐增加;男性与女性的VRC血药浓度具有统计学差异,表现为男性平均浓度高于女性。结论VRC的血药浓度受性别、年龄多种因素的影响,个体差异较大,进行个体化治疗时需监测血药浓度,以保障用药安全和有效。OBJECTIVE To evaluate the effect factors of plasma concentration of voriconazole(VRC),and to provide reference for the rational use of VRC in clinic.METHODS UPLC-MS/MS was used to detect VRC concentration in plasma with cyproheptadine as internal standard.Electrospray ion source and positive ionizing pattern was used,and quantitative analysis was conducted in the multiple reaction monitoring modes with product ion transitions of m/z 350.4127.1 and m/z 288.4→96.1 for VRC and internal standard,respectively.The data of 1630 patients who underwent therapeutic drug monitoring(TDM)of VRC were analyzed.RESULTS A total of 3758 times of VRC were monitored in 1630 hospitalized patients,including 1098 males and 532 females.The C_(min) of VRC was significantly different among individuals,and the average C_(min) was 3.47±4.01 mg.L^(-1)1.Among them,2605 cases(69.32%)were within the recommended concentration range(0.5-5.0 mg·L^(-1)).The C_(min) of VRC in different age groups were statistically different.With the increase of the age,the C_(min) of VRC gradually increased.The C_(min) of VRC in men and women was also statistically different,and the Chmin of VRC in men was higher than that in women.CONCLUSION The plasma concentration of VRC is susceptible to a variety of factors,such as gender and age.The plasma concentration of VRC should be monitored individually to ensure its safety.

关 键 词：伏立康唑 血药浓度 超高效液相色谱-质谱联用 治疗药物浓度监测 个体化治疗 影响因素 

分 类 号：R917[医药卫生—药物分析学]