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肖桂荣, 刘真真, 唐光敏. 隐球菌脑膜炎患者伏立康唑脑脊液浓度与血液浓度的临床分析[J]. 四川大学学报(医学版), 2023, 54(1): 192-197. DOI: 10.12182/20230160206
引用本文: 肖桂荣, 刘真真, 唐光敏. 隐球菌脑膜炎患者伏立康唑脑脊液浓度与血液浓度的临床分析[J]. 四川大学学报(医学版), 2023, 54(1): 192-197. DOI: 10.12182/20230160206
XIAO Gui-rong, LIU Zhen-zhen, TANG Guang-min. Clinical Analysis of Voriconazole Concentrations in Cerebrospinal Fluid and Blood in Patients with Ryptococcal Meningitis[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(1): 192-197. DOI: 10.12182/20230160206
Citation: XIAO Gui-rong, LIU Zhen-zhen, TANG Guang-min. Clinical Analysis of Voriconazole Concentrations in Cerebrospinal Fluid and Blood in Patients with Ryptococcal Meningitis[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(1): 192-197. DOI: 10.12182/20230160206

隐球菌脑膜炎患者伏立康唑脑脊液浓度与血液浓度的临床分析

Clinical Analysis of Voriconazole Concentrations in Cerebrospinal Fluid and Blood in Patients with Ryptococcal Meningitis

  • 摘要:
      目的  探索伏立康唑在隐球菌脑膜炎患者中枢神经系统的分布浓度及其关系。
      方法  回顾性分析25例非HIV感染的隐球菌脑膜炎成人患者的伏立康唑脑脊液谷浓度与血液谷浓度,并探索影响脑脊液/血液浓度比值的患者因素。
      结果  伏立康唑血液谷浓度范围0.38~8.56 mg/L,中位数(P25,P75)为1.81(1.40,3.84) mg/L。伏立康唑脑脊液谷浓度范围0.17~3.92 mg/L,中位数(P25, P75)为1.02 (0.54,1.84) mg/L。伏立康唑脑脊液浓度与脑脊液有核细胞数呈负相关,但无统计学意义(r=−0.377,P=0.063)。伏立康唑脑脊液浓度与血液浓度呈正相关(r=0.736,P<0.001),脑脊液/血液浓度比值中位数(P25,P75)为0.43(0.34,0.68)。脑脊液/血液浓度比值与年龄、体表面积、影像学改变(脑积水)或颅内压无关。
      结论  伏立康唑脑脊液浓度与血液浓度呈正相关,且未发现影响其比值的因素。

     

    Abstract:
      Objective  To investigate the concentrations of voriconazole (VCZ) in the central nervous system (CNS) of patients with cryptococcal meningitis and the relationship thereof.
      Methods  We retrospectively analyzed the trough concentration of VCZ in the cerebrospinal fluid (CSF) and the blood of 25 adult patients who had cryptococcal meningitis, and who were not infected with HIV. We also examined patient-level characteristics that could contribute to the differences in CSF/plasma VCZ concentration ratio.
      Results   The trough concentration of VCZ in plasma ranged from 0.38 to 8.56 mg/L, and the median (P25, P75) was 1.81 (1.40, 3.84) mg/L. The trough concentration of VCZ in CSF ranged from 0.17 to 3.92 mg/L, and the median (P25, P75) was 1.02 (0.54, 1.84) mg/L. The CSF VCZ trough concentration showed a slight negative correlation with the nucleated cell counts in CSF, but the correlation was not statistically significant (r=−0.377, P=0.063). There was a positive correlation between VCZ concentrations in CSF and that in the plasma (r=0.736, P<0.001), and the median (P25, P75) CSF/plasma ratio was 0.43 (0.34, 0.68). The CSF/plasma ratio did not statistically correlate with age, body surface area (BSA), radiology changes (hydrocephalus), or intracranial pressure.
      Conclusion  There is a positive correlation between VCZ concentration in CSF and VCZ concentration in the plasma, and no influencing factors of CSF/plasma ratio were found.

     

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