Analysis of independent risk factors for voriconazole-related liver injury in elderly patients with hypoproteinemia
- VernacularTitle:老年低蛋白血症患者发生伏立康唑相关肝损伤的独立危险因素分析
- Author:
Lijuan ZHOU
1
;
Meng HE
1
;
Wei ZHANG
1
;
Na WANG
1
;
Huihong LI
1
;
Minghui SHEN
1
;
Weiwei JIN
2
Author Information
1. Dept. of Pharmacy，Zhengzhou Central Hospital Affiliated to Zhengzhou University，Zhengzhou 450007，China
2. General Office，Zhengzhou Central Hospital Affiliated to Zhengzhou University，Zhengzhou 450007，China
- Publication Type:Journal Article
- Keywords:
voriconazole;
liver injury;
elderly;
hypoproteinemia;
minimum concentration;
inflammatory factor;
independent
- From:
China Pharmacy
2024;35(24):3035-3040
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the independent risk factors of voriconazole （VCZ）-related liver injury in elderly patients with hypoproteinemia. METHODS Elderly patients with invasive fungal infection and hypoproteinemia who were hospitalized in the respiratory intensive care unit of our hospital and treated with VCZ from August 2020 to July 2023 were selected. They were divided into group A （liver injury group） and group B （non-liver injury group） based on whether the liver injury occurred after using VCZ. Pearson correlation analysis was used to analyze the correlation between minimum concentration （cmin） of VCZ and inflammatory factor[C-reactive protein （CRP）， procalcitonin （PCT）， interleukin-6 （IL-6）]， as well as liver function [alanine transaminase （ALT）， aspartate transaminase （AST）， alkaline phosphatase （ALP）， gamma-glutamyl transpeptidase （GGT）， total bilirubin （TBIL）]； univariate analysis was performed by using χ 2 test； Logistic regression analysis was used to analyze the independent risk factors affecting the occurrence of liver injury. RESULTS A total of 320 patients were included in the study， of whom 56 developed liver injury， with an incidence of 17.50%. The VCZ cmin in group A was significantly higher than group B （P＝ 0.021）. CRP， PCT， IL-6， and TBIL were correlated with VCZ cmin （P＜0.05）. CRP， PCT， IL-6， and TBIL had a significant impact on VCZ cmin （P＜0.05）. VCZ cmin， PCT， and TBIL were independent risk factors for liver injury （P＜0.05）. The patients with VCZ cmin≥3.76 mg/L had a significantly increased risk of liver injury. CONCLUSIONS VCZ cmin， PCT， and TBIL are independent risk factors for the occurrence of liver injury in elderly patients with hypoproteinemia. For patients with high PCT and TBIL， VCZ cmin and liver function should be closely monitored during VCZ treatment to reduce the risk of liver injury.
