ObjectiveTo summarize the occurrence rules of adverse reactions/events of voriconazole, analyze the reasons of adverse reactions/events, and provide reference for clinical medication. MethodsUse China National Knowledge Infrastructure, Vip Journal Integration Platform and Wanfang Data Knowledge Service Platform to search the literatures published in 2015 and before with "voriconazole" "adverse reaction" and "adverse event", classify the adverse reactions/events according to gender, age, system-organs, drug combination, occurrence time, and outcome, and analyze the occurrence regularity and reasons of adverse reactions/events. ResultsA total of 29 literatures were searched, including 44 cases. In all the adverse reactions/events, elderly patients were the most (18 cases with the age of 61-80 years old, occupying 40.9%; 13 cases with >80 years old, occupying 29.5%). Adverse reactions/events mainly involved central nervous system (45 cases, 59.2%). Proton pump inhibitors (5 cases) were the more common drug combination in the 7 drug combination cases. Most adverse reactions/events occurred in 1-7 days after medication (35 cases, 79.5%). The outcome of adverse reactions/events included 39 improvement/recovery, 1 death, and 4 unknown. ConclusionUsing voriconazole should consider the drug characteristics. Choose the drug according to the specific condition of patients, at the same time pay attention to drug interactions, contraindications, and so on. If necessary, genetic testing and therapeutic drug monitoring can be done in order to reduce the occurrence of adverse drug reactions/events.
ObjectiveTo evaluate the predictive value of the high-sensitivity cardiac troponin I (hs-cTnI) in patients with acute pulmonary embolism (APE). MethodsIn a retrospective cohort study,272 consecutive patients with APE were reviewed and the 30-days death and in-hospital adverse events were evaluated. The patients were classified according to hs-cTnI value into a high hs-cTnI group and a low hs-cTnI group. The simple pulmonary embolism severity index (sPESI) was used for clinical risk determination. The adverse event was defined as intravenous thrombolytic therapy,noninvasive ventilator support to maintain oxygen saturation >90% and suffered with severe complications. The correlations of hs-cTnI with sPESI score,30-days adverse events and mortality were analyzed. The Kaplan-Meier curves and the log-rank test were used to compare time-to-event survival. Stepwise multivariate logistic regression analysis models were used to determine the incremental prognostic value of sPESI score and hs-cTnI. ResultsThe incidence of 30-day death (6.1%),renal failure (14.6%),bleeding (13.4%) and thrombolytic therapy (7.9%) were higher in the high hs-cTnI group than those in the low hs-cTnI group (P values were 0.009,<0.001,0.018 and 0.003,respectively). The patients with sPESI ≥1 and low hs-cTnI had greater free adverse events survival (P=0.005). hs-cTnI provided incremental predictive value for in-hospital adverse events,beyond the sPESI score (P<0.001). Conclusionhs-cTnI has excellent negative predictive value of APE prognosis,especially when used combined with sPESI score.