瓦尔甘西克洛维尔预防的陷 根据脏功能调整脏移植患者的剂量
Nathalie Hammer1, Linard Hoessly2, Fadi Haidar3
1Service of Nephrology and Hypertension, Inselspital, Bern, Switzerland.
概括
对于移植接受者 (KTR) 进行的瓦尔甘西克洛维尔 (VGC) 预防通常是不适当的剂量,近一半的VGC剂量是不正确的. 然而,这种剂量问题并没有显著影响KTR中CMV感染率或整体安全结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 传染性疾病 传染性疾病
背景情况:
- 瓦尔甘西克洛维尔 (VGC) 在移植接受者 (KTR) 中对细胞巨乳病毒 (CMV) 预防至关重要.
- 建议根据功能调整VGC剂量,但对剂量准确性和临床结果的真实数据有限.
研究的目的:
- 根据功能来评估KTR中VGC剂量的适当性.
- 调查VGC剂量与突破性临床显著的CMV感染 (csCMVi) 之间的关联.
- 探索KTR中VGC剂量和细胞衰竭之间的关系.
主要方法:
- 2010-2020年成人D+/R-和R+/TGKTR的回顾性观察研究.
- 分析了来自131名接受VGC预防的KTR的1,032次VGC剂量周入口.
- 评估VGC剂量的适当性,突破性csCMVi和细胞衰竭.
主要成果:
- 44.6%的VGC剂量是适当的,而22.7%的剂量不足,32.8%的剂量过多.
- 突破性csCMVi发生在14.5%的患者中,与VGC剂量没有显著的关联.
- 过量服用VGC与淋巴衰竭有显著的关联 (OR5.27,p=0.004).
结论:
- 不适当的VGC剂量在KTR预防中很常见.
- 目前在KTR的VGC剂量实践似乎没有显著影响CMV感染疗效或整体安全性.
- 淋巴缺血是与KTR中VGC过量剂量相关的潜在安全问题.
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