苯妥英钠影响aIlo-HSCT病人伏立康唑血药浓度及癫痫预防1例 并文献复习

[中图分类号]R457；R969 ［文献标志码］A [文章编号] 2096-5532（2025）04-0618-04

doi：10.11712/jms.2096-5532.2025.61.113

[Abstract]ObjetiveToinvestigate theefectof phenytoin sodiumon theplasma concentrationof voriconazole inpatient receivingallogeeichemaopoeticstmcelltransplantatio（all-HSCT），sellasdoseadjustmentstrategsduringoadis trationandtheselectionofpreventive strategiesforbusulfan-induced seizures.MethodsThechanges intheplasmaconcentrationof voriconazolewereanalyzedforapatientwhoreceivedco-administrationofphenytoinsodiumandvoriconazoleduringallo HSCT，followed by withdrawalof phenytoinsodium.Wanfang Data，VIP，andCNKIweresearched withthe Chinese wordscorre sponding to“voriconazole”，“phenytoin sodium”，and“seizure”assearchterms，and PubMed databasewas searched with“voriconazole”，“phenytoin”，nd“seizure”assearchterms.Ananalysiswasperformedforthearticlesontheinfluenceofphenytoinso diumon the plasma concentrationofvoriconazole and the preventive strategies forbusulfan-induced seizures.ResultsIna patientwhoreceivedco-administrationofphenytoinsodiumandvoriconazoleduringall-HSCT，thetroughconcentrationof vorico nazole ranged from 0.23 to 3.73mg/L ，which increased to 1.80mg/L on day 17 after withdrawal of phenytoin sodium. The literaturreviewshowedthatwhen voriconazolewasadministeredincombinationwith phenytoinsodium，andthedoseofvoriconazole increased to 400mg each time，twicea day，the reduction in the plasma concentration of voriconazole could be offset.Levetiracetam wasrecommended forthepreventionof busulfan-inducedseizures.ConclusionWithdrawalof phenytoinsodiumduringallo HSCTcan afectthe plasmaconcentrationof voriconazole.Forpatients requiring concomitantuseofphenytoin sodium and voriconazole，itisrecommendedtomonitortheplasmaconcentrationofvoriconazole.Ifnecesary，thedoseofvoriconazolecouldbe doubled，or levetiracetam may be used as the preferred drug for the prevention of busulfan-induced seizures.

[Key words] phenytoin；voriconazole；hematopoietic stem cell transplantation;seizures；plasma concentration;case report

异基因造血干细胞移植是治疗多种血液病的有效方法[1-6]，而移植预处理是allo-HSCT的重要环节[7-9]。（剩余10233字）