三氮唑类抗真菌药的治疗药物监测研究进展

Advances in therapeutic drug monitoring for triazole antifungal agents

近年来,真菌感染,尤其是深部真菌感染严重地威胁到患者的健康和生命,因此抗真菌药物的研究开发及临床应用日益受到重视。三氮唑类抗真菌药是临床使用最广泛的抗真菌药物,其临床疗效得到了广泛的肯定。代表药物有氟康唑(Fluconazole)、伊曲康唑(Itraconazole)、伏立康唑(Voriconazole)、泊沙康唑(Posaconazole)等。由于在吸收、代谢和排泄等方面的差异和药物相互作用的影响,导致许多抗真菌药物血药浓度的个体差异较大。临床实践表明抗真菌药物的血药浓度与其疗效和毒副作用有相关性,对其进行治疗药物监测可优化治疗效果同时降低毒副作用。本文就近年来国内外三氮唑类抗真菌药物治疗药物监测的研究进展进行综述。

In recent years, the fungal infection, especially the invasive deep fungal infection has becomes a major threat to patients＇ health and life. Hence, the research and application of antifungal drugs have been paid much more attention than before. The triazole antifungals, such as fluconazole, itraconazole, voriconazole, are some of the most widely used antifungal agents in clinical. Due to the different absorption, metabolism, elimination and interaction with combined medications, the triazole antifungals exhibit remarkable individual difference in blood concentration. Related clinical trials have proved the reasonable relationship, between thedrug concentration and the clinical effect, at the same time the relationship between drug concentration and toxicity has also been identified. The use of therapeutic drug monitoring （TDM）for these triazoles can optimize their therapeutic effects while reduce possible side effects. This paper summarizes the domestic and international researches on therapeutic drug monitoring of triazole antifungal drugs.