中国临床药理学杂志2024，Vol.40Issue(12)：1822-1826,5.DOI:10.13699/j.cnki.1001-6821.2024.12.026
卡泊芬净血药浓度预测模型对血液科真菌感染患者预测准确性的验证与评价
Validation and evaluation of the predictive accuracy of the caspofungin blood concentration prediction model in patients with fungal infections in the haematology department
摘要
Abstract
Objective To study the factors influencing the blood concentration of caspofungin(CPFG),construct a prediction model,and validate the predictive effect of the model,so as to provide reference for the individualised dosing of patients with fungal infections in haematology.Methods Seventy-five patients admitted to the Department of Haematology,General Hospital of Tianjin Medical University,who were treated with CPFG for antifungal therapy during the period of March 2021 to June 2022 were selected as the study subjects,and CPFG blood concentration monitoring was carried out to explore the influencing factors of CPFG blood concentration and to construct a prediction model accordingly.Hosmer-Lemeshow(H-L)was used to test the goodness-of-fit of the model,and another 30 patients were selected as the verification group,and the predictive effect of the model was verified by the receiver's operating characteristics(ROC)curve.Results The mean blood concentrations of the patients at 0.5,9 and 24 h were(12.54±4.38),(6.80±2.76),(4.13±2.16)μg·mL-1,and the mean AUC0-24h were(152.05±57.60)µg·mL-1·h.AUC0-24h was lower than the reference value(98 μg·mL-1·h)in two patients.The results of correlation analysis showed that gender showed a correlation with 0.5 h blood concentration(P＜0.05),and there was no correlation with the rest of the two time points blood concentration and AUC0-24h(P＞0.05).Body weight and albumin(Alb)concentration showed correlation with 0.5,9,24 h blood drug concentration and AUC0-24 h(P＜0.05),and the rest of the indicators showed no correlation with blood drug concentration and AUC0_24h at each time point(P＞0.05).The results of multifactorial analysis showed that the factors influencing the patients'0.5 h blood concentration were gender,Alb concentration and body weight,and the factors influencing the 9 and 24 h blood concentration and AUC0-24h were Alb concentration and body weight(P＜0.05).Correlation analysis showed that the daily dose was positively correlated with the plasma concentration of CPFG at 0.5,9 and 24 h and AUC0-24h(P＜0.05).The results of multivariate analysis showed that the daily dose was also one of the influencing factors of the plasma concentration of CPFG(P＜0.05).ROC curve shows that the model has good prediction ability.Conclusion Body weight and Alb are significantly associated with CPFG blood concentrations and area under the drug-time curve,which can be used as a basis for preventive risk avoidance.关键词
卡泊芬净/真菌感染/血药浓度/影响因素/预测模型Key words
caspofungin/fungal infections/blood concentration/influencing factors/predictive modelling分类
医药卫生引用本文复制引用
谢栋,毕重文,段蓉,王一浩,袁恒杰,李正翔..卡泊芬净血药浓度预测模型对血液科真菌感染患者预测准确性的验证与评价[J].中国临床药理学杂志,2024,40(12):1822-1826,5.基金项目
白求恩·医学科学研究基金资助项目(B21028FN) （B21028FN）
