目的 研究伏立康唑导致视觉损害的发生规律及特点。方法 收集PubMed、Embase、Web of Science、中国知网、万方、维普数据库纳入的伏立康唑导致视觉损害的病例。利用Excel软件进行统计分析患者的性别、年龄、用法用量、发生时间、临床表现、不良反应处理及转归等信息。结果 共纳入75例患者,其中男性53例(70.67%),女性22例(29.33%);年龄9~96岁,年龄≥60岁者48例,占比(64.00%)最大。视觉损害多发生在用药后第1~3天,共51例(68.92%)。持续时间集中在1~7d,共49例(72.06%)。视觉损害表现为幻视、畏光、视力模糊、色视、复视。结论 伏立康唑导致的视觉损害大部分患者预后良好,但发生时间及持续时间跨度较大,与药品说明书的描述有差异,建议用药期间应全程监护患者视力改变,尽可能完善眼科检查、伏立康唑谷浓度,有条件者可完善基因监测,指导临床用药,减少不良反应的发生。

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

咸阳市重点研发计划科技专项项目[咸科发(2020)11号]