| 摘要: |
| 目的:探讨2 岁以下儿童伏立康唑(VCZ)体质量次剂量校正浓度( CDR) 的影响因素,为VCZ 临床合理用药提供参考。
方法:收集2017-2024 年我院儿科78 例接受VCZ 预防或治疗侵袭性真菌感染住院患儿资料,收集相关人口学、用药信息、生化
检验等资料。采用非参数检验方法进行组间比较;采用线性混合效应回归模型和分段线性混合效应回归模型分析VCZ-CDR 的
影响因素。结果:78 例患儿共监测530 例次VCZ 谷浓度,58. 1%达到治疗范围,VCZ 谷浓度中位值为1. 56(0. 62,2. 76) μg/ mL。
每日2 次给药或每日3 次给药,不同谷浓度组VCZ 体质量剂量比较,差异均无统计学意义(P>0. 05)。多变量线性混合效应回
归分析结果显示,给药频次、白蛋白、血肌酐、炎症因子C 反应蛋白( CRP) 水平对VCZ-CDR 的影响有统计学意义( P<0. 05)。
CRP =47. 40 mg/ L 为VCZ-CDR 敏感性截点。结论:VCZ 给药频次、白蛋白、血肌酐、炎症因子CRP 水平是影响2 岁以下儿童
VCZ 血药浓度的因素。 |
| 关键词: 儿童 伏立康唑 治疗药物监测 C 反应蛋白 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.05.002 |
|
| 基金项目:基金项目:广东省医学科学技术研究基金,编号A2024205;广东省医院协会药学科研专项基金,编号2022YXKY16。 |
|
| Influencing Factors of Voriconazole Pharmacokinetics in Children Less Than 2 Years Old Based on theMixed-Effects Model |
| Chen Juan, Zhao Boxin, Wen Jianyun, Zheng Ping, Yang Li, Li Yilei |
| (Nanfang Hospital of Southern Medical University,
Guangzhou 510515, China) |
| Abstract: |
| Objective: To investigate the influencing factors of body weight concentration-to-dose ratio (CDR) of voriconazole (VCZ) in children less than 2 years old, and to provide reference for the rational clinical application of VCZ. Methods: Data of 78 children
admitted into our hospital for prevention or treatment of invasive fungal infection with VCZ from 2017 to 2024 were collected. Relevant
demographic, medication, and biochemical test information were collected. Group comparisons were conducted by using non-parametric
tests, while linear mixed-effects regression models and piecewise linear mixed-effects regression models were employed to analyze factors
influencing VCZ-CDR. Results: A total of 530 trough concentrations of VCZ were monitored in 78 children, 58. 1% of the trough
concentrations reached the therapeutic window. The median trough concentration of VCZ was 1. 56 (0. 62, 2. 76) μg/ mL. Regardless of
whether the drug was administered twice or three times daily, no statistically significant difference was observed in the weight-based VCZ
dosage across different trough concentration groups (P>0. 05). Multivariable linear mixed-effects regression analysis revealed that dosing
frequency, albumin levels, serum creatinine, and inflammatory marker C-reactive protein (CRP) had statistically significant effects on
VCZ-CDR (P<0. 05). The sensitivity cutoff for CRP affecting VCZ-CDR was 47. 40 mg/ L. Conclusion: The dosing frequency of VCZ,
albumin, serum creatinine, |
| Key words: children voriconazole therapeutic drug monitoring C-reactive protein |
