20例伏立康唑致肝损伤危险因素分析

Analysis of risk factors of liver injury induced by voriconazole in 20 cases

目的 探讨使用伏立康唑患者发生肝损伤的相关危险因素,筛查肝损伤高危人群。方法 选取2015年1月至2021年12月在延边大学附属医院接受伏立康唑治疗的患者进行回顾性分析,对符合要求的患者收集其基础信息、用药史、实验室指标等。结果 共纳入230例患者,有20例发生肝损伤,发生率为8.7%。二元logistic回归分析结果显示,用药后低蛋白血症(OR=0.887, P=0.014)及联合使用质子泵抑制剂(OR=0.338, P=0.035)是伏立康唑致肝损伤的危险因素。结论 临床使用伏立康唑时对低蛋白血症及合并使用质子泵抑制剂的患者应给予高度重视,对患者进行肝功能及血药浓度监测,通过开展药学监护服务制定个体化给药方案。

Objective To explore the risk factors of liver injury in patients using voriconazole,and to screen the high-risk population of liver injury.Methods A retrospective study was conducted on patients treated with voriconazole in Yanbian University Hospital from January 2015 to December 2021.For each eligible patient,demographic details,medical history,laboratory parameters were collected from the hospital information system(HIS).Results Among 230 patients included in this study,20 patients had liver injury,with an incidence of 8.7%.The results of the binary logistic regression analysis showed that hypoproteinemia(OR=0.887,P=0.014)and combined use of proton pump inhibitors(PPIs)(OR=0.338,P=0.035)were independent risk factors of liver injury induced by voriconazole induced.Conclusion During clinical use of voriconazole,patients with hypoproteinemia and combined use of PPIs should be given more attention.In addition,the liver function and blood drug concentration should be monitored,and the individualizd drug administration plan should be carried out by pharmace utical care services.