中国临床药学杂志2025，Vol.34Issue(5)：361-366,6.DOI:10.19577/j.1007-4406.2025.05.007
新疆地区侵袭性真菌感染儿童伏立康唑血药浓度分布特征及影响因素分析
Analysis of the distribution characteristics and influencing factors of plasma concentrations of voriconazole in children with invasive fungal infections in Xinjiang
摘要
Abstract
AIM To evaluate the distribution characteristics and influencing factors of voriconazole trough concentrations in pediatric patients with invasive fungal infections in the Xinjiang Uygur population.METHODS A total of 201 pediatric patients with invasive fungal infections in the Xinjiang Uygur population,who were hospitalized between June 2020 and July 2023 were enrolled.High-performance liquid chromatography-mass spectrometry was used to determine the trough concentrations of voriconazole in 201 patients,and the CYP2C19 gene polymorphisms were detected by first-generation sequencing technology.RESULTS There were 9 pediatric patients with a trough plasma concentration of less than 0.5 μg·mL-1 and 22 pediatric patients with a trough concentration of voriconazole greater than 5.0 μg·mL-1.Additionally,170 pediatric patients had trough concentrations of voriconazole ranging from 0.5 to 5.0 μg·mL-1.The doses of voriconazole were positively correlated with plasma trough concentrations(r=0.127,P＜0.05).Pediatric patients over 14 years of age had a significantly higher concentration to dose ratio(CDR)than those in other age groups(P＜0.05).The CDR value in pediatric patients with body mass index(BMI)greater than 18.5 was significantly higher than that with BMI less than 18.5(P＜0.05).The CDR value of voriconazole in intravenous patients was significantly higher than that in patients with the oral route(P＜0.05).The CDR value of voriconazole in patients receiving concomitant hepatic enzyme inducers during voriconazole administration was significantly lower than that in patients receiving concomitant hepatic enzyme inhibitors(P＜0.05).The CDR of voriconazole in ultrarapid metabolizer children was significantly lower than that in extensive-metabolizer,intermediate metabolizer,and poor-metabolizer children(P＜0.05).CONCLUSION The plasma trough concentrations of voriconazole in pediatric patients with invasive fungal infections in Xinjiang predominantly fall within the range of 0.5 to 5.0 μg·mL-1.Age,BMI,route of administration,and CYP2C19 gene polymorphisms could significantly affect voriconazole trough concentrations.关键词
伏立康唑/侵袭性真菌感染/血浆谷浓度/CYP2C19Key words
voriconazole/invasive fungal infections/plasma trough concentration/CYP2C19分类
药学引用本文复制引用
张惠兰,赵婷,李红健,于鲁海..新疆地区侵袭性真菌感染儿童伏立康唑血药浓度分布特征及影响因素分析[J].中国临床药学杂志,2025,34(5):361-366,6.基金项目
新疆维吾尔自治区人民医院科研基金资助项目(编号20210132) （编号20210132）
