摘要
目的探讨伏立康唑血药浓度与侵袭性真菌感染(IFI)患者CYP2C19基因多态性的相关性。方法选取2019年12月至2023年12月徐州医科大学附属医院重症监护室收治的使用伏立康唑治疗IFI的165例患者为研究对象,通过Sanger测序法检测CYP2C19^(*)3 G>A基因型,酶放大免疫法测定伏立康唑谷浓度;按CYP2C19^(*)3基因型(GG/GA)分组,统计临床有效率;采用多元回归分析伏立康唑血药浓度可能的影响因素。结果165例患者伏立康唑谷浓度为(4.93±3.49)mg/L。其中,谷浓度达标91例,超标66例,未达标8例。CYP2C19^(*)3 G>AGG型148例,GA型17例,未发现AA型。GG型患者谷浓度为(4.74±3.47)mg/L,显著低于GA型的(6.60±3.32)mg/L(t=-2.107,P=0.037)。GA型临床有效率为94.12%,显著高于GG型的58.78%(χ^(2)=8.116,P=0.004)。年龄和CYP2C19^(*)3基因型是伏立康唑血药浓度独立影响因素(P<0.05)。结论相较于CYP2C19^(*)3其他基因型,CYP2C19^(*)3 GA型患者伏立康唑血药浓度更高,临床疗效更优,年龄增长和CYP2C19^(*)3 GA基因型是血药浓度升高的独立影响因素。
Objective To investigate the correlation between blood drug concentration of voriconazole and CYP2C19 gene polymorphism in patients with invasive fungal infections(IFI).Methods A total of 165 IFI patients treated with voriconazole and admitted to the intensive care unit of the affiliated Hospital of Xuzhou Medical University from December 2019 to December 2023 were selected,the CYP2C19^(*)3 G>A genotype was detected by Sanger sequencing method;the voriconazole plasma drug concentration was determined by enzyme amplification immunoassay technique;participants were divided into three groups according to CYP2C19^(*)3 genotype(GG/GA)and the clinical effective rate was calculated.The influencing factors of voriconazole trough concentration were identified through multivariable regression analysis.Results The trough concentration of voriconazole in 165 patients was(4.93±3.49)mg/L,of which 91 cases met the standard,66 cases exceeded the standard,and 8 cases did not meet the standard.There were 148 cases of GG type,17 cases of GA type,and 0 cases of AA type in CYP2C19^(*)3 G>A.The trough concentration of GG type patients was(4.74±3.47)mg/L,which was significantly lower than(6.60±3.32)mg/L in GA type(t=-2.107,P=0.037).The clinical effective rate of GA type was 94.12%,which was significantly higher than 58.78% in GG type(χ^(2)=8.116,P=0.004).Age and CYP2C19^(*)3 genotype are independent influencing factors of voriconazole blood concentration(P<0.05).Conclusion Compared to patients carrying other CYP2C19^(*)3 genotypes,patients with the CYP2C19^(*)3 genotype exhibit significantly higher trough concentrations of voriconazole and demonstrate superior clinical efficacy.Advancing age and the CYP2C19^(*)3 genotype are independent influencing factors associated with elevated blood drug concentrations.
作者
高杏
张倩
邱小松
GAO Xing;ZHANG Qian;QIU Xiaosong(The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,China 221004;Xuzhou Mineral Group General Hospital,Xuzhou,Jiangsu,China 221004)
出处
《中国药业》
2025年第16期69-72,共4页
China Pharmaceuticals
基金
江苏省研究型医院学会精益化用药-石药专项科研基金[JY202111]。
