目的 研究伏立康唑?qū)е乱曈X損害的發(fā)生規(guī)律及特點。方法 收集PubMed、Embase、Web of Science、中國知網(wǎng)、萬方、維普數(shù)據(jù)庫納入的伏立康唑?qū)е乱曈X損害的病例。利用Excel軟件進行統(tǒng)計分析患者的性別、年齡、用法用量、發(fā)生時間、臨床表現(xiàn)、不良反應(yīng)處理及轉(zhuǎn)歸等信息。結(jié)果 共納入75例患者,其中男性53例(70.67%),女性22例(29.33%);年齡9~96歲,年齡≥60歲者48例,占比(64.00%)最大。視覺損害多發(fā)生在用藥后第1~3天,共51例(68.92%)。持續(xù)時間集中在1~7d,共49例(72.06%)。視覺損害表現(xiàn)為幻視、畏光、視力模糊、色視、復(fù)視。結(jié)論 伏立康唑?qū)е碌囊曈X損害大部分患者預(yù)后良好,但發(fā)生時間及持續(xù)時間跨度較大,與藥品說明書的描述有差異,建議用藥期間應(yīng)全程監(jiān)護患者視力改變,盡可能完善眼科檢查、伏立康唑谷濃度,有條件者可完善基因監(jiān)測,指導(dǎo)臨床用藥,減少不良反應(yīng)的發(fā)生。

Objective To study the regularity and characteristics of visual damage caused by voriconazole. Methods Visual impairment cases caused by voriconazole were collected from PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP databases. Excel software was used for statistical analysis of patients’ gender, age, usage and dosage, occurrence time, clinical manifestations, treatment of adverse reactions and outcomes. Results A total of 75 patients were included, including 53 males (70.67%) and 22 females (29.33%). 48 cases (64.00%) aged from 9 to 96 years old were older than 60 years old. Visual impairment occurred in 51 cases (68.92%) on the 1st to 3rd day after medication. The duration was concentrated in 1 to 7 days, 49 cases (72.06%). Visual impairments include hallucinations, photophobia, blurred vision, chromatism and diplopia. Conclusion Most patients with visual impairment caused by voriconazole have a good prognosis, but the occurrence time and duration span are large, which is different from the description in the drug instructions. It is recommended to monitor the visual changes of patients throughout the course of medication, improve the ophthalmic examination and voriconazole valley concentration as much as possible, and improve the gene monitoring if conditions exist to guide clinical medication and reduce the occurrence of adverse reactions.

R978.5

咸陽市重點研發(fā)計劃科技專項項目[咸科發(fā)(2020)11號]