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目的评价儿童与青少年及成人用伏立康唑的安全性和有效性以及药代动力学特征差异。方法检索Pub Med、Em Base、Cochrane图书馆、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库,Clinical Trials数据库,从建库至2015年3月。按纳入与排除标准筛选文献,资料提取和质量评价,用Rev Man 5.1进行Meta分析。结果共纳入9篇研究,共314例患者。儿童使用伏立康唑的感染治疗有效率、目标谷浓度达标率、肝毒性发生率、视觉异常发生率、神经毒性发生率、AUC/Dose(iv)、C_(trough)(po)与青少年及成人比较,差异无统计学意义(P>0.05)。然而在AUC/Dose(po)、C_(max)/Dose(iv)、C_(max)/Dose(po)、C_(trough)(iv)差异有统计学意义(P<0.05)。结论儿童在使用伏立康唑后的安全性和有效性可能与青少年及成人相似或低于青少年及成人,药代动力学方面儿童与青少年及成人有明显的区别。
Objective To evaluate the safety and efficacy of voriconazole for children and adolescents and adults, and the differences in pharmacokinetic characteristics. Methods PubMed, Em Base, Cochrane Library, CNKI, CBM, Wanfang database and Clinical Trials database were searched from the database to March 2015. According to inclusion and exclusion criteria screening literature, data extraction and quality evaluation, Meta-analysis with Rev Man 5.1. Results A total of 9 studies were included, 314 patients in total. The effective rate of treatment with voriconazole in children, the compliance rate of target trough, the incidence of hepatotoxicity, the incidence of visual abnormalities, the incidence of neurotoxicity, AUC / Dose (iv), trough (po) compared with adolescents and adults, The difference was not statistically significant (P> 0.05). However, there was significant difference between AUC / Dose (po), C max / Dose (iv), C max / Dose (po) and C trough (iv) (P <0.05). Conclusions The safety and efficacy of voriconazole in children may be similar to or lower than those in adolescents and adults, and there is a clear difference in pharmacokinetics between children and adolescents and adults.