[1]程林,翁邦碧,向荣凤,等.伏立康唑所致低血钾和低血钠及其与伏立康唑谷浓度的关系研究[J].第三军医大学学报,2020,42(13):1350-1354.
 CHENG Lin,WENG Bangbi,XIANG Rongfeng,et al.Voriconazole-induced hypokalemia and hyponatremia and their correlations with voriconazole trough concentration[J].J Third Mil Med Univ,2020,42(13):1350-1354.
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伏立康唑所致低血钾和低血钠及其与伏立康唑谷浓度的关系研究(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第13期
页码:
1350-1354
栏目:
临床医学
出版日期:
2020-07-15

文章信息/Info

Title:
Voriconazole-induced hypokalemia and hyponatremia and their correlations with voriconazole trough concentration
作者:
程林翁邦碧向荣凤夏培元
陆军军医大学(第三军医大学)第一附属医院药学部 
Author(s):
CHENG Lin WENG Bangbi XIANG Rongfeng XIA Peiyuan

Department of Pharmacy, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
伏立康唑治疗药物监测不良反应低血钾低血钠
Keywords:
 
分类号:
R591.1; R969.3; R978.5
文献标志码:
A
摘要:

目的探讨肺部侵袭性真菌感染患者中伏立康唑所致低血钾和低血钠的发生情况及其与伏立康唑谷浓度的相关性。方法对2017年10月8日至2019年4月30日我院收治的进行伏立康唑治疗药物监测患者的临床资料进行回顾性分析。收集患者的性别、年龄、体质量、基础疾病、真菌感染类型、给药方式、给药剂量、伏立康唑谷浓度、血钾浓度、血钠浓度、给药后出现低血钾和低血钠的时间。对伏立康唑谷浓度与血钾、血钠浓度的相关性进行Pearson相关性分析。结果共纳入142例肺部侵袭性真菌感染患者,267个伏立康唑谷浓度。患者以男性为主(64.1%);基础疾病以白血病(26.8%)和高血压(32.4%)为主,其次为糖尿病、慢性阻塞性肺疾病、肾移植和冠状动脉粥样硬化性心脏病;感染真菌以曲霉菌为主(40.8%)。伏立康唑谷浓度为2.9(1.6,4.9)μg/mL,范围0.4~15.5 μg/mL。共42例患者出现低血钾,占29.6%;21例患者出现低血钠,占14.8%。伏立康唑使用后1~5 d出现低血钾和低血钠的比例最高,分别占57.1%和42.9%。出现低血钾和低血钠患者的给药方式均以静脉滴注为主。口服伏立康唑后出现低血钾的时间长,静脉滴注伏立康唑后出现低血钾的时间短。患者血钾和血钠与伏立康唑谷浓度不存在相关性(r=0.001,P=0.989;r=0.150,P=0.052)。结论在常规治疗剂量下,静脉滴注伏立康唑引起低血钾和低血钠的比例较高,且多发生于伏立康唑使用后早期,临床应用中应注意此不良反应。

Abstract:

ObjectiveTo investigate the incidence rates of voriconazole-induced hypokalemia and hyponatremia and their correlations with voriconazole trough concentration in the patients with lung invasive aspergillosis. MethodsThe clinical data of the patients receiving therapeutic drug monitoring for voriconazole due to lung invasive aspergillosis in our hospital from 8 October, 2017 to 30 April, 2019 were collected and retrospectively analyzed. Sex, age, body weight, baseline diseases, types of fungal infection, route of administration, daily voriconazole dose, voriconazole trough concentration, serum potassium and sodium concentrations, and the times of hypokalemia and hyponatremia after administration were collected in all the patients. The relationships of voriconazole trough concentration with serum potassium and sodium concentrations were analyzed with Pearson’s correlation analysis. ResultsA total of 142 patients with lung invasive aspergillosis were enrolled, with 267 voriconazole trough concentrations. The patients were mainly men (64.1%). Their mainly baseline diseases were majorly leukaemia (26.8%) and hypertension (32.4%), followed by diabetes mellitus, chronic obstructive pulmonary disease, kidney transplantation, and coronary atherosclerotic heart disease. The most common infected fungus was Aspergillus (40.8%). The voriconazole trough concentration was 2.9 (1.6, 4.9) μg/mL, with a range of 0.4~15.5 μg/mL among the patients, 42 patients suffered from hypokalemia, accounting for 29.6%, and 21 patients suffered  from hyponatremia, accounting for 14.8%. Hypokalemia and hyponatremia were mainly observed in 1 to 5 d after voriconazole administration, accounting for 57.1% and 42.9%, respectively. Most of the patients with hypokalemia and hyponatremia received the agent through intravenous injection. The duration of hypokalemia after oral administration was long, while the time with intravenous injection was short. There were no correlations of voriconazole trough concentration with serum potassium and sodium (r=0.001, P=0.989; r=0.150, P=0.052). ConclusionUnder routine dose, the incidences of hypokalemia and hyponatremia are quite high after intravenous injection of voriconazole, and they mainly occur in the early time after administration. Special attention should be paid to the adverse effects in clinical practice. 

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更新日期/Last Update: 2020-07-06