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卡泊芬净的群体药代动力学-药效动力学研究进展
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| 篇名： | 卡泊芬净的群体药代动力学-药效动力学研究进展 |
| TITLE： | Advances in population pharmacokinetics-pharmacodynamics of caspofungin |
| 摘要： | 卡泊芬净是首个批准临床使用的棘白菌素类抗真菌药物，用于治疗由念珠菌或者曲霉菌引起的严重真菌感染，目前已是侵袭性念珠菌的一线推荐治疗药物和侵袭性曲霉菌的二线治疗药物，且具有良好的安全性和耐受性。但是，卡泊芬净在不同患者人群中依然存在药代动力学变异大、体内暴露低等治疗风险。本文回顾了卡泊芬净在儿童和成人中开展的群体药代动力学-药效动力学研究。结果显示，体表面积是影响儿童患者卡泊芬净分布和清除的主要因素。在成人患者中，二室模型能较好地描述卡泊芬净的体内过程，影响其药代动力学参数的主要协变量是体质量和白蛋白浓度。卡泊芬净的药效可能与血药浓度-时间曲线下面积与最低抑菌浓度的比值（AUC/MIC）、峰浓度与最小有效浓度的比值（cmax/MEC）等药代动力学-药效动力学参数相关。 |
| ABSTRACT： | Caspofungin is the firs t echinocandin antifungal drug approved for serious fungal infections caused by Candida or Aspergillus. Currently ，caspofungin has been recommended as the first-line treatment for invasive Candida and the second-line treatment for invasive Aspergillus，for its safety and tolerability. However ，there are still probability of pharmacokinetic variability and the risk of low exposure in different populations. Herein the population pharmacokinetics-pharmacodynamics studies of caspofungin in children and adults were reviewed. The results indicate that the body surface area was the main factor affecting the distribution and clearance of caspofungin in pediatric patients. In adults ，the two-compartment model fits the caspofungin behavior best in vivo with the primary covariates of body weight and albumin level. The efficacy of caspofungin might be related to pharmacokinetics-pharmacodynamics parameters ，such as the ratio of area under blood concentration time curve to minimum inhibitory concentration （AUC/MIC），the ratio of peak concentration to minimum effective concentration （cmax/MEC）. |
| 期刊： | 2022年第33卷第05期 |
| 作者： | 李曼娜，林晓莹，黄银璇，谢慧 |
| AUTHORS： | LI Manna ，LIN Xiaoying ，HUANG Yinxuan ，XIE Hui |
| 关键字： | 卡泊芬净；群体药代动力学-药效动力学；个体化给药；儿童；成人 |
| KEYWORDS： | caspofungin；population pharmacokinetics-pharmacodynamics ；individualized medication ；children；adult |
| 阅读数： | 576 次 |
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