内科理论与实践 ›› 2024, Vol. 19 ›› Issue (01): 31-35.doi: 10.16138/j.1673-6087.2024.01.06
收稿日期:
2023-10-26
出版日期:
2024-02-29
发布日期:
2024-04-28
通讯作者:
方洁
E-mail:fj40517@rjh.com.cn
FANG Jiea(), CHEN Chaoa, ZHOU Minb
Received:
2023-10-26
Online:
2024-02-29
Published:
2024-04-28
Contact:
FANG Jie
E-mail:fj40517@rjh.com.cn
摘要:
耶氏肺孢子菌肺炎(Pneumocystis jiroveci pneumonia,PJP)是人类免疫缺陷病毒(human immunodeficiency virus,HIV)患者较为常见和严重的机会性感染之一。随着免疫抑制剂及化疗药物等的使用,目前国内报道PJP多数为非HIV免疫抑制患者。复方磺胺甲噁唑(sulfamethoxazole complex, SMZco)是治疗PJP的一线药物,其药动学存在广泛的个体差异。本文通过引用1例药物监测下SMZco治疗PJP的病例,从SMZco的药代动力学、剂量相关不良反应以及最佳治疗剂量研究等方面进行系统综述,旨在表明对PJP患者进行SMZco治疗药物监测的重要性,通过药物监测以确保患者达到有效治疗浓度,减少不良反应的发生。
中图分类号:
方洁, 陈超, 周敏. 对耶氏肺孢子菌肺炎患者进行复方磺胺甲噁唑治疗药物监测的重要性研究[J]. 内科理论与实践, 2024, 19(01): 31-35.
FANG Jie, CHEN Chao, ZHOU Min. Importance of drug monitoring for compound sulfamethoxazole therapy in patients with Pneumocystis jiroveci pneumonia[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(01): 31-35.
表1
患者在治疗期间的SMZco给药剂量、血钾浓度、C反应蛋白、降钙素原和血药浓度
用药时间* | 给药剂量 | 检测时间* | 血钾浓度(μmol/L) | C反应蛋白(mg/L) | 降钙素原(ng/mL) | Cmin(μg/mL) | Cmax(μg/mL) |
---|---|---|---|---|---|---|---|
D1 | 132 | ||||||
D2 | 142 | 2.04 | |||||
D3~D11 | 0.96g/次,qid | D3 | 3.96 | 89 | 2.15 | ||
D4 | 4.01 | 57 | 1.47 | ||||
D5 | 4.26 | 24 | 0.79 | 125 | |||
D6 | 4.67 | 15 | 0.48 | ||||
D7 | 5.24 | 10 | |||||
D8 | 5.14 | 8 | 0.24 | ||||
D9 | 6.24 | 7 | 0.28 | 188 | |||
D10 | 5.49 | 16 | 0.51 | ||||
D12~D14 | 0.96 g/次,q12h | D12 | 5.01 | 17 | 0.74 | ||
D14 | 4.32 | 29 | 0.7 | ||||
D15~D37 | 0.96 g/次,tid | D15 | 24 | 0.5 | 59.7 | ||
D20 | 5.07 | ||||||
D23 | 4.93 | 8 | 0.23 | 94.99 | |||
D29 | 4.37 | 96.84 | |||||
D32 | 3.98 | 115.35 | |||||
D36 | 4.43 | 7 | 0.12 | 100.27 | |||
D37 | 7 |
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