[Factors Influencing and Adverse Reactions of Voriconazole Clearance in Patients with Hematological Diseases].

To monitor the changes of voriconazole minimum concentration(Cmin) in patients with hematological diseases, and evaluate the factors influencing and adverse reactions of voriconazole clearance in patients with hematological diseases, so as to provide a theoretical basis for reasonable clinical use of voriconazole.136 patients with hematological diseases who used voriconazole in Wuhan NO.1 Hospital from May 2018 to December 2019 were selected. The correlation between C-reactive protein, albumin, creatinine and voriconazole Cmin were analyzed, and the changes of voriconazole Cmin after glucocorticoid treatment was also detected. In addition, stratified analysis was used to explore the adverse events of voriconazole.Among 136 patients, 77 were male (56.62%) and 59 were female (43.38%). There were positive correlations between voriconazole Cmin and C-reactive protein and creatinine levels (r=0.277, r=0.208), while voriconazole Cmin was negatively correlated with albumin level (r=-2.673). Voriconazole Cmin in patients treated with glucocorticoid was decreased significantly (P<0.05). In addition, sratified analysis of voriconazole Cmin showed that compared with voriconazole Cmin 1.0-5.0 mg/L group, the incidence of adverse reactions of visual impairment in voriconazole Cmin> 5.0 mg/L group was increased (χ2=4.318, P=0.038).The levels of C-reactive protein, albumin and creatinine are closely related to the voriconazole Cmin, which indicate that inflammation and hyponutrition may prevent the clearance of voriconazole in patients with hematological diseases. It is necessary to monitor the voriconazole Cmin of patients with hematological diseases, and adjust the dosage in time to reduce adverse reactions.血液病患者伏立康唑清除的影响因素及其不良反应.通过监测血液系统疾病患者伏立康唑谷浓度（Cmin），评估血液病患者伏立康唑清除的影响因素及其不良反应，为伏立康唑的临床合理使用提供理论依据。.选取武汉市第一医院2018年5月至2019年12月给予伏立康唑预防及治疗的血液病患者136例，分析患者C-反应蛋白、白蛋白及肌酐与伏立康唑Cmin的相关性，检测糖皮质激素处理后伏立康唑Cmin水平的改变，并通过分层分析探究伏立康唑不良反应事件。.136例患者中，男性77例（56.62%），女性59例（43.38%）。患者伏立康唑Cmin与C-反应蛋白水平和肌酐水平呈正相关性（r=0.277，r= 0.208）；而伏立康唑Cmin与白蛋白水平呈负相关性（r=-2.673）。给予糖皮质激素治疗的患者伏立康唑Cmin显著降低 （P<0.05）。伏立康唑Cmin分层分析发现，与Cmin为1.0-5.0 mg/L组相比，伏立康唑Cmin>5.0 mg/L组患者视觉障碍的发生率明显升高（χ2=4.318，P=0.038）。.C-反应蛋白、白蛋白及肌酐水平与伏立康唑血药浓度密切相关，炎症及低营养状态可能抑制血液病患者伏立康唑的清除。有必要对使用伏立康唑的血液病患者进行血药浓度监测，并及时调整给药剂量，以减少不良反应。.