1例卡泊芬净致低蛋白血症合并肺部真菌感染患者肝损伤报道

Drug-induced liver injury in patient with hypoproteinemia and pulmonary fungal infection caused by caspofungin:a case report

本文通过对1例低蛋白血症合并肺部真菌感染患者在抗真菌治疗过程中肝功能异常的原因分析及药学监护,探讨卡泊芬净在低蛋白血症患者中引起肝损伤的机制。卡泊芬净在低蛋白血症患者体内游离水平升高,导致肝脏内血药浓度上升,从而增加卡泊芬净致药物性肝损伤的风险。临床药师参与临床药物治疗有助于及时发现问题,优化药物治疗方案。

The authors analyzed the causes of abnormal elevation of liver function in a patient with hypoproteinemia and pulmonary fungal infection during antifungal therapy and discussed the mechanism of liver injury caused by caspofungin in patients with hypoproteinemia.Increased free level of caspofungin in patients with hypoproteinemia leads to increased serum concentration of caspofungin in the liver,which increases the risk of drug-induced liver injury.The participation of clinical pharmacists in clinical drug treatment is helpful to discover the pharmacokinetic characteristics of drugs and optimize drug treatment schemes.