北京地区近10年伏立康唑相关肝损伤分析

Voriconazole-induced liver injury in Beijing:A real-world study in recent ten years

目的研究北京地区伏立康唑相关肝损伤发生情况及特点,为临床合理使用伏立康唑及处理伏立康唑相关肝损伤提供参考。方法根据《药物性肝损伤诊治指南(2015年版)》,对2011-01-01至2021-06-30的108例北京地区伏立康唑相关肝损伤进行回顾性分析,对患者用药情况、临床表现、药物不良反应发生时间、转归情况、肝损伤类型及分级、保肝药使用情况等进行统计分析。结果108例伏立康唑相关肝损伤发生时间平均为(7±6)d,药物不良反应结局均为好转或痊愈。肝损伤类型以混合型多见,轻中度肝损伤占96.88%,肝损伤严重程度分级,其中1级占92.19%,2级占4.69%,3级3.13%。83.3%的患者停止使用伏立康唑,且58.3%的患者使用了保肝药物,平均保肝药物品种数为1.9±1.2。结论伏立康唑用药期间需严密监护患者肝功能,尤其在用药前1周内,且应严格掌握停药标准及保肝药物使用。

Objective To investigate the occurrence and characteristics of liver injury induced by voricaonazole in the real world to provide reference for the safe use of voriconazole in clinical practice.Methods A total of 108 liver injury patients associated with voriconazole in Beijing from 2011-01-01 to 2021-06-30 were analyzed according to the guideline of diagnosis and treatment of drug-induced liver injury(2015).Clinical manifestations,medication occurrence time and outcome of adverse drug reaction(ADR),types and grades of liver injury,use of liver-protecting drugs were statistically analyzed.Results Among the 108 cases of liver injury patients,the average occurrence time of ADR was(7±6)d after medication.Mixed type was most common,mild and moderate liver injury accounted for 96.88%.According to the severity of liver injury,grade 1 accounted for 92.19%,grade 2 accounted for 4.69%,and grade 3 accounted for 3.13%.Voriconazole was discontinued in 83.3%of the patients,while liver protecting drugs was administered in 58.3%of the patients,with an average of 1.9±1.2.Conclusion It is suggested that liver function of patients should be closely monitored during the treatment of voriconazole,especially the first week after medication,and the indications of drug withdrawal and the use of liver-protecting drugs should be strictly controlled.