Correlation Between Serum Voriconazole Concentration and Hepatic and Renal Function Indices in Pediatric Patients with Invasive Pulmonary Fungal Infections
Objective To explore the influence of serum voriconazole concentration on hepatic and renal function in pediatric patients with pulmonary fungal infections,providing reference for rational drug use in clinical practice.Methods A retrospective analysis was conducted on clinical data of pediatric patients with pulmonary fungal infections admitted to Henan Provincial People's Hospital from August 2021 to August 2022.Serum voriconazole concentration was stratified by quartiles,and differences in age,hepatic and renal function,and concomitant medication were compared among groups.Results A total of 103 pediatric patients were included in this study.The median voriconazole trough concentration was 2.59(0.21,13.74)mg·L-1,with 80 cases(77.67％)achieving the target concentration range(0.5-5.0 mg·L-1).Stratified by quartiles of serum voriconazole concentration,four groups(Q1-Q4)were formed:Q1 group(26 cases)0.44(0.21,0.62)mg·L-1,Q2 group(26 cases)1.34(0.72,1.81)mg·L-1,Q3 group(26 cases)2.58(1.82,3.54)mg·L-1,and Q4 group(25 cases)6.11(3.71,13.74)mg·L-1.There were differences in aspartate aminotransferase(AST)and indirect bilirubin(IBIL)between different quartiles of voriconazole concentration(P＜0.05),while other hepatic and renal function indices showed no statistically significant differences(P＞0.05).In female pediatric patients,there were differences in IBIL between different quartiles of voriconazole concentration(P＜0.05).In male pediatric patients,AST showed statistically significant differences between different quartiles of voriconazole concentration(P＜0.05).There was a positive correlation between voriconazole concentration and AST in male patients(P＜0.05).Conclusion Serum voriconazole concentration and hepatic function indices differ in male pediatric patients and are correlated,with a significant impact of concentration.Individualized dosing should be considered in clinical practice,with attention to gender differences.
万方数据
维普
