Abstract:

Objective To investigate the guiding role of CYP2C19 gene polymorphism in predicting vori⁃ conazole related adverse reactions in patients with Aspergillus infection and to provide evidence for individualized drug use in such patients. Methods Retrospective non⁃randomized control method was used to select the patients who were diagnosed as invasive pulmonary aspergillosis and used voriconazole in our hospital from January 2018 to December 2019. Clinical records and course records of all patients were consulted to determine whether there were adverse reactions and types. Results Totally 168 patients were selected，including 84 patients with detected gene polymorphism in experiment group and another 84 patients in control group. There was no significant difference in age，gender and weight between the two groups（P > 0.05）. Fast，medium and slow metabolisms in genomic patients were 39.29%，45.24% and 15.47% respectively. There were significant differences in the types of adverse drug reactions（ADR）in 168 patients. The incidence of liver dysfunction was the highest（46.23%），followed by renal dysfunction（17.86%）and gastrointestinal discomfort（14.28%）. There was significant difference in the incidence of ADR between the experiment group and the control group（P < 0.05）and that was higher in the exper⁃ iment group. Inter⁃group comparison of ADR incidence in patients with fast，medium and slow metabolism showed statistical significance（P < 0.05），and ADR incidence in patients with slow metabolism（53.8%）was the highest， followed by those with intermediate metabolism（52.6%）and those with fast metabolism（24.2%）. Conclusion Identification of genotype of CYP2C19 in patients with pulmonary Aspergillus using voriconazole is helpful for the targeted disposal of drug⁃related ADRs and improving the safety of drug use. 

Key words:

CYP2C19 gene polymorphism, voriconazole, ADR