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泊沙康唑联用PPI对恶性血液病患者血药浓度和侵袭性真菌感染的影响
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| 篇名： | 泊沙康唑联用PPI对恶性血液病患者血药浓度和侵袭性真菌感染的影响 |
| TITLE： | Effect of posaconazole combined with proton pump inhibitors on blood concentrations and invasive fungal infec-tion in patients with malignant hematological disorders |
| 摘要： | 目的 探讨泊沙康唑联用质子泵抑制剂（PPI）对恶性血液病患者血药浓度和侵袭性真菌病（IFD）发生风险的影响。方法选择2020年12月－2021年12月我院血液内科收治的恶性血液病患者40例，按随机数字表法分为对照组（20例）和观察组（20例）。对照组患者给予泊沙康唑口服混悬液，观察组患者给予泊沙康唑口服混悬液联合PPI。比较两组患者的IFD发生率，血药浓度达标率，发生IFD预防到突破时间，IFD相关病死率，感染患者治疗情况及两组患者服用泊沙康唑第7、14、21、28天的血药浓度；记录两组患者用药期间的不良事件发生情况。结果观察组有2例患者、对照组有9例患者因服用泊沙康唑不足7d即出院而终止研究。观察组患者的IFD发生率显著高于对照组，血药浓度达标率显著低于对照组（P＜0.05）。两组患者发生IFD预防到突破时间、IFD相关病死率、感染患者治疗情况、不良事件发生率比较，差异均无统计学意义（P＞0.05）。用药第7天，观察组患者的泊沙康唑血药浓度显著低于对照组（P＜0.05）；用药第14天，两组患者的泊沙康唑血药浓度比较，差异无统计学意义（P＞0.05）。结论泊沙康唑联用PPI可降低恶性血液病患者的血药浓度，增加IFD发生风险，临床应尽量避免二者联用或在治疗药物监测指导下联用。 |
| ABSTRACT： | OBJECTIVE To explore the effects of posaconazole combined with proton pump inhibitors （PPI） on the blood concentration and the risk of invasive fungal disease （IFD） in patients with malignant hematological disorder. METHODS In accordance with the random number table method， 40 patients with malignant hematological disorders who were admitted to the hematology department of our hospital between December 2020 and December 2021 were chosen and divided into control group （20 cases） and observation group （20 cases）. The control group received Posaconazole oral suspension alone， while the observation group received Posaconazole oral suspension combined with PPI. The incidence of IFD， attainment rate of blood concentration， the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients， and blood concentrations of posaconazole on 7th， 14th， 21st， and 28th day after posaconazole application were compared between 2 groups； the occurrence of adverse events during drug administration in the two groups was recorded. RESULTS The study was stopped because 2 patients in the observation group and 9 patients in the control group received hospital departures after taking posaconazole for fewer than 7 days. The incidence of IFD in the observation group was significantly higher than control group， and the attainment rate of blood concentration in the observation group was significantly lower than control group （P＜0.05）. There was no significant difference in the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients and the incidence of adverse events （P＞ 0.05）. The blood concentration of posaconazole in the observation group was significantly lower than control group on 7th day of medication （P＜0.05）； there was no significant in blood concentration of posaconazole between 2 groups on the 14th day of medication （P＞0.05）. CONCLUSIONS Posaconazole combined with PPI can reduce the blood concentration of patients with malignant hematological disorders， increase the risk of IFD. Clinical practice should try to avoid the combination of the two or use them under the guidance of therapeutic drug monitoring. |
| 期刊： | 2023年第34卷第10期 |
| 作者： | 屈若尘；于静；王子阳；刘明霖；刘佳慧；刘新颖；崔欣宇；王紫怡；刘琰 |
| AUTHORS： | QU Ruochen， YU Jing，WANG Ziyang，LIU Minglin，LIU Jiahui，LIU Xinying，CUI Xinyu，WANG Ziyi，LIU Yan |
| 关键字： | 泊沙康唑；质子泵抑制剂；血药浓度；侵袭性真菌病；合理用药 |
| KEYWORDS： | posaconazole； proton pump inhibitors； blood concentration； invasive fungal disease； rational drug use |
| 阅读数： | 242 次 |
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