Page 93 - 《中国药房》2026年10期
P. 93

AML 患者血浆中维奈克拉、白消安和伏立康唑浓度测定方法的

          建立与应用
                           Δ


          张振华    1, 2* ,张梦茹 ,郭傲翔 ,陈 卉 ,乡世健 ,周本杰 ,葛冰琛                       1, 3 # [1.中山大学第七附属医院(深圳)药
                                                        1, 3
                                              1, 3
                                                                 1, 3
                           1, 2
                                     1, 3
          学部,广东 深圳 518107;2.中山大学药学院(深圳),广东 深圳 518107;3.深圳中药活性物质筛选与转化研
          究重点实验室,广东 深圳 518107]
          中图分类号  R969      文献标志码  A      文章编号  1001-0408(2026)10-1323-06
          DOI  10.6039/j.issn.1001-0408.2026.10.15


          摘  要  目的  建立同时测定急性髓系白血病(AML)患者血浆中维奈克拉、白消安和伏立康唑浓度的方法并应用于临床。方法
          血浆样品经乙腈沉淀蛋白后,分别以维奈克拉-D8、白消安-D8、泊沙康唑为内标,采用液相色谱-串联质谱(LC-MS/MS)法检测。以
          Phenomenex Kinetex  C18为色谱柱,以0.1%甲酸溶液(含2 mmol/L乙酸铵)-0.1%甲酸乙腈溶液为流动相进行梯度洗脱;流速为0.8
                         ®
          mL/min;柱温为40 ℃;进样量为5 μL;运行时间为3.10 min;采用电喷雾离子源,以多反应监测方式进行正离子扫描,用于定量分
          析的离子对包括m/z 868.4→636.3(维奈克拉)、m/z 264.1→151.1(白消安)、m/z 350.1→224.0(伏立康唑)等。采用上述LC-MS/MS
          法测定10例联合用药AML患者体内维奈克拉、伏立康唑的血药浓度和5例行异基因造血干细胞移植预处理患者体内白消安的血
          药浓度。结果  维奈克拉、白消安、伏立康唑检测质量浓度的线性范围分别为50~10 000、15~3 000、50~10 000 ng/mL(R ≥0.999 0),
                                                                                                     2
          定量下限分别为 50、15、50 ng/mL;3 种待测药物的日内、日间精密度的 RSD 均低于 10%,准确度(相对误差)为-10.00%~
          12.96%;平均提取回收率为92.54%~100.95%,平均基质效应为89.98%~101.49%,稀释可靠性可覆盖试验样品所用的稀释倍数,
          稳定性试验的相对误差绝对值均不高于16.25%。纳入患者体内维奈克拉、白消安、伏立康唑的血药浓度分别为496.20~4 250.45、
          233.48~2 002.28、475.51~5 710.18 ng/mL。结论  所建LC-MS/MS法快速、灵敏、操作简便,可用于AML患者维奈克拉、白消安和
          伏立康唑血药浓度治疗药物监测。
          关键词  维奈克拉;白消安;伏立康唑;急性髓系白血病;液相色谱-串联质谱法;治疗药物监测

          Establishment  and  application  of  a  determination  method  for  plasma  concentrations  of  venetoclax,
          busulfan and voriconazole in patients with acute myeloid leukemia
          ZHANG Zhenhua ,ZHANG Mengru ,GUO Aoxiang ,CHEN Hui ,XIANG Shijian ,ZHOU Benjie ,
                                                            1, 3
                                            1, 2
                                                                         1, 3
                         1, 2
                                                                                                          1, 3
                                                                                          1, 3
          GE Bingchen [1.  Dept.  of  Pharmacy,  the  Seventh  Affiliated  Hospital (Shenzhen),  Sun  Yat-sen  University,
                     1, 3
          Guangdong  Shenzhen  518107,  China;2.  School  of  Pharmaceutical  Sciences  (Shenzhen),  Sun  Yat-sen
          University,  Guangdong  Shenzhen  518107,  China;3.  Shenzhen  Key  Laboratory  of  Chinese  Medicine  Active
          Substance Screening and Translational Research, Guangdong Shenzhen 518107, China]
          ABSTRACT   OBJECTIVE  To  establish  a  method  for  simultaneous  determination  of  venetoclax,  busulfan  and  voriconazole  in
          plasma  of  patients  with  acute  myeloid  leukemia (AML),  and  apply  it  clinically.  METHODS  Plasma  samples  were  subjected  to
          protein  precipitation  using  acetonitrile  and  subsequently  analyzed  by  liquid  chromatography-tandem  mass  spectrometry (LC-MS/
          MS)  using  venetoclax-D8,  busulfan-D8  and  posaconazole  as  internal  standards.  The  separation  was  performed  on  a  Phenomenex
          Kinetex  C18 column with a mobile phase composed of 0.1% formic acid solution (2 mmol/L ammonium acetate)-0.1% formic acid
               ®
          in  acetonitrile (gradient  elution)  at  a  flow  rate  of  0.8  mL/min.  The  column  temperature  was  set  at  40  ℃,  the  sample  size  was  5
          μL,  and  the  total  run  time  was  3.10  min.  An  electrospray  ionization  source  was  employed,  and  positive  ion  scanning  was
          conducted  using  multiple  reaction  monitoring  mode.  The  ion  pairs  used  for  quantitative  analysis  included  m/z  868.4→636.3
         (venetoclax), m/z 264.1→151.1 (busulfan), and m/z 350.1→224.0 (voriconazole). The above LC-MS/MS method was adopted to
                                                             determine   plasma   concentrations   of   venetoclax   and
             Δ 基金项目 深圳市重点实验室组建项目(No.ZDSYS20220606-
                                                             voriconazole  in  10  AML  patients,  as  well  as  plasma
          100801003);中国医药教育协会2025年医院高质量发展与药物创新研
                                                             concentration of busulfan in 5 patients undergoing conditioning
          究专项课题(No.2025-PJZXKT-31)
             * 第一作者 硕 士 。 研 究 方 向 :临 床 药 理 。 E-mail:zhangzhh-  treatment   for   allogeneic   hematopoietic   stem   cell
          225@alumni.sysu.edu.cn                             transplantation.  RESULTS  The  linear  ranges  of  venetoclax,
             # 通信作者 主管药师,硕士。研究方向:体内药物分析及个体化                  busulfan  and  voriconazole  were  50-10  000,  15-3  000  and  50-
          给药。E-mail:gebingchen@sysush.com                    10  000  ng/mL,  respectively (R ≥0.999  0),  with  lower  limits
                                                                                      2

          中国药房  2026年第37卷第10期                                              China Pharmacy  2026 Vol. 37  No. 10    · 1323 ·
   88   89   90   91   92   93   94   95   96   97   98