【摘要】：目的:為伏立康唑臨床個體化用藥提供參考。方法:匯總伏立康唑?qū)熐购桶咨钪榫淖畹鸵志鷿舛?MIC)分布情況,以及伏立康唑在不同人群中的藥動學參數(shù),采用水晶球軟件11.1.2.4對同一人群不同給藥方案和不同人群同一給藥方案進行蒙特卡洛模擬(MCS),以達標概率(PTA)和累積反應(yīng)分數(shù)(CFR)為評價指標。結(jié)果:當免疫功能低下兒童的給藥劑量為4、6 mg/kg時,MIC≤0.125 mg/L即可滿足PTA90%;當給藥劑量增加至8 mg/kg時,MIC≤0.25 mg/L才可滿足PTA90%。對于應(yīng)用相同給藥方案(4 mg/kg)的不用人群而言,免疫功能低下青少年的MIC≤0.25 mg/L,健康成年人、造血干細胞移植患者、免疫功能低下成年人的MIC≤0.5 mg/L時,可滿足PTA90%。免疫功能低下兒童不同給藥劑量(4、6、8 mg/kg)以及給藥劑量同為4 mg/kg的不同人群(免疫功能低下青少年、健康成年人、造血干細胞移植患者、免疫功能低下成年人)對煙曲霉的CFR值分別為42.53%、58.41%、77.74%、70.16%、89.40%、93.72%、95.42%,對白色念珠菌的CFR值分別為96.68%、97.13%、97.94%、97.54%、98.07%、98.28%、98.35%。結(jié)論:上述納入研究的不同人群的各種給藥方案均能有效控制白色念珠菌感染,而對于免疫功能低下兒童和青少年則需適當增加給藥劑量以滿足煙曲霉感染臨床治療的需要。
[Abstract]:Objective: to provide reference for individual clinical use of voriconazole. Methods: the distribution of minimal inhibitory concentration (MIC) of Voliconazole against Aspergillus fumigatus and Candida albicans was summarized, and the pharmacokinetic parameters of Voliconazole in different populations were summarized. Monte Carlo simulation (MCS), was carried out with the crystal ball software 11.1.2.4 for different administration schemes of the same population and the same administration scheme of different populations. The probability of reaching the standard (PTA) and the cumulative response score (CFR) were used as the evaluation indexes. Results: when the dosage was 4, 6 mg/kg, the MIC 鈮，

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