Relationship between voriconazole trough concentration and liver injury in elderly patients with lung invasive aspergillosis

Lin CHENG; Bangbi WENG; Rongfeng XIANG; Fengjun SUN

doi:10.16016/j.1000-5404.202005071

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Relationship between voriconazole trough concentration and liver injury in elderly patients with lung invasive aspergillosis

更新时间：2026-01-09

- Relationship between voriconazole trough concentration and liver injury in elderly patients with lung invasive aspergillosis
- Journal of Third Military Medical University Vol. 42, Issue 19, Pages: 1944-1949(2020)
- 作者机构：
- 作者简介：
- 基金信息：
  
  the Promotion Plan for Military Medical Innovation Capacity of the First Affiliated Hospital of Army Medical University(SWH2019QNLC-05)
- DOI：10.16016/j.1000-5404.202005071
  CLC：
- Received：10 May 2020，
  
  Published：15 October 2020
- 稿件说明：
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Lin CHENG, Bangbi WENG, Rongfeng XIANG, et al. Relationship between voriconazole trough concentration and liver injury in elderly patients with lung invasive aspergillosis[J]. Journal of Third Military Medical University, 2020, 42(19): 1944-1949.
DOI：

Lin CHENG, Bangbi WENG, Rongfeng XIANG, et al. Relationship between voriconazole trough concentration and liver injury in elderly patients with lung invasive aspergillosis[J]. Journal of Third Military Medical University, 2020, 42(19): 1944-1949. DOI： 10.16016/j.1000-5404.202005071.

摘要

Abstract

Objective

To investigate the relationship between voriconazole trough concentration and liver injury in elderly patients with lung invasive aspergillosis.

Methods

The clinical data of patients receiving voriconazole therapeutic drug monitoring matched with the inclusion criteria

who admitted to our hospital from 1 January

2018 to 30 June

2019 were retrospectively analyzed. Patients were divided into elderly group (≥60 years) and adult group (≥18~ < 60 years) according to age. The route of administration

daily voriconazole dose

voriconazole trough concentration

and liver injury of patients were compared between the two groups.

Results

A total of 179 patients with lung invasive aspergillosis were included in

with 329 voriconazole trough concentration. There were 87 patients in elderly group

with 131 voriconazole trough concentration. There were 92 patients in elderly group

with 198 voriconaz

ole trough concentration. Most patients in the elderly group received an intravenous drip

which was higher than that in adult group (

0.01). The voriconazole dosing was similar in the two cohorts (

0.05). The voriconazole trough concentration in elderly group was 3.86 (2.02

6.00) μg/mL

which was higher than 2.6 (1.5

4.0)μg/mL in adult group (

0.01). The proportion of voriconazole trough concentrations higher than 5 μg/mL in the elderly group was higher than that in the adult group (

0.01). The incidence rate of alanine aminotransferase (ALT) increasing in elderly group was lower than that in the adult group (

0.01). The incidence rate of albumin decreasing in elderly group was higher than that in the adult group (

0.01). The incidence of increased alkaline phosphatase (ALP)

ALT

and gamma-glutamyl transpeptidase (GGT) concentrations and decreased albumin level was higher in the elderly group than that in the adult group when the voriconazole trough concentration was higher than 5 μg/mL (

0.05). There were no correlations of voriconazole trough concentration with ALP

ALT

aspartate aminotransferase (AST)

GGT

total bilirubin

and albumin in elderly group (

=0.018

0.154

0.166

-0.171

-0.138

-0.118

0.05). There were positive correlation of voriconazole trough concentration with AST and total bilirubin in adult group (

=0.267

0.618

0.01). There was negative correlation between voriconazole trough concentration and albumin in adult group (

=-0.214

0.05).

Conclusion

The voriconazole trough concentration in elderly patients was higher than that in adult patients; the elderly patients have the high incidence of liver injury when the voriconazole trough concentration was higher than 5 μg/mL; there were no correlations of voriconazole trough concentration and liver function indexes in elderly patients.

关键词

Keywords

references

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