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泊沙康唑联用 PPI 对恶性血液病患者血药浓度和侵袭性真菌感
染的影响
Δ
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1， 2 #
屈若尘 1， 2＊ ，于 静 ，王子阳 ，刘明霖 ，刘佳慧 ，刘新颖 ，崔欣宇 ，王紫怡 ，刘 琰 （1.河北医科大学第一
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1， 2
医院临床药学部，石家庄 050000；2.河北省人工智能临床药学技术创新中心，石家庄 050000；3.河北医科大
学药学院，石家庄 050000；4.河北医科大学第一医院血液内科，石家庄 050000）
中图分类号 R969.3 文献标志码 A 文章编号 1001-0408（2023）10-1237-05
DOI 10.6039/j.issn.1001-0408.2023.10.16
摘 要 目的 探讨泊沙康唑联用质子泵抑制剂（PPI）对恶性血液病患者血药浓度和侵袭性真菌病（IFD）发生风险的影响。方法
选择 2020 年 12 月－2021 年 12 月我院血液内科收治的恶性血液病患者 40 例，按随机数字表法分为对照组（20 例）和观察组（20
例）。对照组患者给予泊沙康唑口服混悬液，观察组患者给予泊沙康唑口服混悬液联合PPI。比较两组患者的IFD发生率，血药浓
度达标率，发生IFD预防到突破时间，IFD相关病死率，感染患者治疗情况及两组患者服用泊沙康唑第7、14、21、28 天的血药浓度；
记录两组患者用药期间的不良事件发生情况。结果 观察组有2例患者、对照组有9例患者因服用泊沙康唑不足7 d即出院而终止
研究。观察组患者的IFD发生率显著高于对照组，血药浓度达标率显著低于对照组（P＜0.05）。两组患者发生IFD预防到突破时
间、IFD相关病死率、感染患者治疗情况、不良事件发生率比较，差异均无统计学意义（P＞0.05）。用药第7 天，观察组患者的泊沙
康唑血药浓度显著低于对照组（P＜0.05）；用药第14天，两组患者的泊沙康唑血药浓度比较，差异无统计学意义（P＞0.05）。结论
泊沙康唑联用 PPI 可降低恶性血液病患者的血药浓度，增加 IFD 发生风险，临床应尽量避免二者联用或在治疗药物监测指导下
联用。
关键词 泊沙康唑；质子泵抑制剂；血药浓度；侵袭性真菌病；合理用药
Effect of posaconazole combined with proton pump inhibitors on blood concentrations and invasive fungal
infection in patients with malignant hematological disorders
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QU Ruochen ，YU Jing ，WANG Ziyang ，LIU Minglin ，LIU Jiahui ，LIU Xinying ，CUI Xinyu ，WANG Ziyi ，
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LIU Yan （1. Dept. of Clinical Pharmacy， the First Hospital of Hebei Medical University， Shijiazhuang
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050000， China；2. Hebei Artificial Intelligence Clinical Pharmacy Technology Innovation Center， Shijiazhuang
050000， China；3. School of Pharmacy， Hebei Medical University， Shijiazhuang 050000， China； 4. Dept. of
Hematology， the First Hosptial of Hebei Medical University， Shijiazhuang 050000， China）
ABSTRACT OBJECTIVE To explore the effects of posaconazole combined with proton pump inhibitors （PPI） on the blood
concentration and the risk of invasive fungal disease （IFD） in patients with malignant hematological disorder. METHODS In
accordance with the random number table method， 40 patients with malignant hematological disorders who were admitted to the
hematology department of our hospital between December 2020 and December 2021 were chosen and divided into control group
（20 cases） and observation group （20 cases）. The control group received Posaconazole oral suspension alone， while the observation
group received Posaconazole oral suspension combined with PPI. The incidence of IFD， attainment rate of blood concentration， the
time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients， and blood
concentrations of posaconazole on 7th， 14th， 21st， and 28th day after posaconazole application were compared between 2 groups；
the occurrence of adverse events during drug administration in the two groups was recorded. RESULTS The study was stopped
because 2 patients in the observation group and 9 patients in the control group received hospital departures after taking posaconazole
for fewer than 7 days. The incidence of IFD in the observation group was significantly higher than control group， and the
attainment rate of blood concentration in the observation group was significantly lower than control group （P＜0.05）. There was no
significant difference in the time from the start of prophylaxis
Δ 基金项目 河北省医学科学研究课题（No.20210368）；医院药学
to IFD onset， the fatality associated with IFD， treatment of
科研项目（天晴专项）重点课题（No.2020-Hbsyxhzd0001）
infected patients and the incidence of adverse events （P＞
＊第一作者 硕士研究生。研究方向：临床药学。电话：0311-
87156670。E-mail：1063915908@qq.com 0.05）. The blood concentration of posaconazole in the
# 通信作者 主 管 药 师 。 研 究 方 向 ：临 床 药 学 。 电 话 ：0311- observation group was significantly lower than control group
87156670。E-mail：ydyyliuyan@163.com on 7th day of medication （P＜0.05）； there was no significant
中国药房 2023年第34卷第10期 China Pharmacy 2023 Vol. 34 No. 10 · 1237 ·
