| 摘要: |
| 目的：评价接受造血干细胞移植（HSCT）患儿中伏立康唑与钙调神经磷酸酶抑制剂环孢素（CsA）或他克莫司（FK506）之间的相互作用。方法：采用前瞻性队列研究方法评估31例接受稳定剂量CsA或FK506并开始使用伏立康唑的同种异体HSCT患儿。在伏立康唑用药前和用药后5~8 d测定CsA或FK506的血药浓度，并在稳态下测定伏立康唑的血药浓度，评估伏立康唑给药前后CsA及FK506的血药浓度变化情况。结果：伏立康唑给药后，CsA的浓度/剂量（C/D）值增加了215.75%（10.16%~706.35%），FK506的C/D增加了239.24%（89.66%~615.00%）（P均<0.01）。伏立康唑对CsA和对FK506血药浓度的影响程度相当（P>0.05）。伏立康唑血药浓度与CsA的C/D增幅之间无相关性（P>0.05），而与FK506的C/D增幅呈正相关（P<0.05）。结论：HSCT患儿联用伏立康唑后，CsA与FK506的血药浓度明显增加，且增加幅度存在显著个体差异 |
| 关键词: 伏立康唑 环孢素 他克莫司 药物相互作用 造血干细胞移植 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2021.12.007 |
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| 基金项目:苏州市产业技术创新专项,编号SYSD2016150;江苏省药学会—奥赛康医院药学基金立项课题,编号A201727。 |
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| Interaction between Voriconazole and Calcineurin Inhibitors in Children Undergoing Hematopoietic Stem Cell Transplantation |
| Yang Mengjie, Wang Mei, Gui Huan |
| (Children’s Hospital of Soochow University, Jiangsu Soochow 215000, China) |
| Abstract: |
| Objective: To evaluate the interaction between voliconazole and calcineurin inhibitors cyclosporine (CsA) or tacrolimus (FK506) in children undergoing hematopoietic stem cell transplantation (HSCT). Methods: A prospective cohort study method was used to evaluate 31 children with allogeneic HSCT who received a steady dose of CsA or FK506 and were started on voriconazole. The blood concentration of CsA or FK506 was measured before and after voriconazole administration of 5 to 8 d, the blood concentration of voriconazole were determined at the steady state, and the changes in blood concentration of CsA or FK506 before and after voriconazole administration were detected. Results: After voriconazole administration, the concentration/dose (C/D) values increased by 215.75% (from 10.16% to 706.35%) for CsA and 239.24% (from 89.66% to 615.00%) for FK506 (P<0.01). Voriconazole had similar effects on CsA and FK506 (P>0.05). There was no correlation between the blood concentration of voriconazole and the C/D increase of CsA (P>0.05), yet there was a positive correlation between the blood concentration of voriconazole and the C/D increase of FK506 (P<0.05). Conclusion: The blood concentration of CsA and FK506 increase significantly after the combination of voriconazole in children with HSCT, and there are significant individual differences in the magnitude of the increase. |
| Key words: voriconazole cyclosporine tacrolimus drug interaction hematopoietic stem cell transplantation |
