Voriconazole maintenance dose prediction mathematical model and construction method and application thereof

Abstract

The invention discloses a mathematical model for predicting voriconazole maintenance dose by integrating multiple factors and application, and relates to the technical field of medical treatment, and the model is prepared by the following steps: (1) determining the influence of CYP2C19 gene polymorphism on the use of voriconazole steady-state plasma concentration (VCZ-Cmin) by invasive fungal infection patients through variance analysis; (2) confirming the influence of CRP, PCT, IL-6 and combined use of a proton pump inhibitor on VCZ-Cmin; (3) confirming the influence of oriented use of voriconazole and non-oriented medication of different CYP2C19 genotypes on the curative effect and adverse reaction of a patient; (4) predicting risk factors influencing the VCZ-Cmin and risk factors influencing the voriconazole maintenance dosage; and (5) establishing a mathematical model for predicting the voriconazole maintenance dose and verifying the model. According to the influence factors and the mathematical prediction model disclosed by the invention, the accuracy of the sustaining dose of the clinically used voriconazole is improved, the drug concentration can be quickly stabilized in a target valley concentration range, the medication of the voriconazole is more accurate, safe and effective, and the adverse reaction is reduced.

Description

technical field [0001] The invention relates to the field of medical technology, in particular to a mathematical model and application for predicting maintenance dose of voriconazole by integrating various factors. Background technique [0002] Voriconazole belongs to the second-generation triazole broad-spectrum antifungal drug, and is commonly used as a first-line drug in the clinical treatment of invasive pulmonary aspergillosis, candidemia and other invasive fungal diseases. Due to the saturable metabolism of voriconazole and its nonlinear pharmacokinetics, the plasma concentration of voriconazole has a great correlation with clinical efficacy and safety. However, many factors affect the metabolic process of voriconazole in the body, making the blood concentration of voriconazole highly variable in different patients, or even in the same patient at different times. Clinically, many patients are often given the same dose of voriconazole in accordance with the instruction...

AI Technical Summary

Problems solved by technology

Clinically, many patients are often given the same dose of voriconazole in accordance with the instructions approved by the State Food and Drug Administration. By continuously measuring whether the blood concentration of voriconazole reaches the target trough concentration range, repeated voriconazole dose adjustments are not achieved. The purpose of clinical precision treatment

[0003] At present, the domestic and foreign literatures have different reports on the factors affecting the plasma concentration of voriconazole, and whether the CYP2C19 gene status can guide the dosage of voriconazole still needs to be studied, and there is no literature that has reached a consistent conclusion on the factors that clearly affect the stable maintenance dose of voriconazole, and based on These risk factors establish a mathematical model for voriconazole administration, which is still a blank

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