伏立康唑是一种广谱的三唑类抗真菌药，真菌感染的患者多有严重的基础疾病，对于体质比较差的患者在进行相关方面的处理时还有可能导致其他的不良反应，所以我们要对伏立康唑的不良反应保持一定的警惕。

Voriconazole is a kind of broad-spectrum triazole antifungal drug. Patients with fungal infection mostly have serious underlying diseases, and other adverse reactions may be caused in the treatment of patients with poor physical constitution. Therefore, we should keep certain vigilance on the adverse reactions of voriconazole.

伏立康唑

　　立康唑不良反应有哪些？1.口服伏立康唑抗真菌，患者出现视觉和精神障碍。患者，男，83岁。因「咳嗽、咳痰10年，气促3年，加重2天」入院。

　　既往有肺结核病史31年，已治愈；2型糖尿病史21年，血糖控制欠佳。由于患者慢性肾功能不全，结合药品说明书推荐剂量和患者个体情况，给予伏立康唑胶囊口服，首剂400mg,之后改为200mg,每12小时1次，此后患者自觉症状好转。第9天早晨，患者出现视物模糊、重影，伴幻觉、失眠，自觉有陌生人说话、墙上长草、有人搬砖等。停药1~3天后，患者视觉、精神症状减轻甚至消失。基因多态性检测示正常，血药浓度（给药第3天、第5天给药前的谷浓度）为

　　2.皮肤色素沉着。患者男，67岁，因「肺部真菌感染」给予伏立康唑治疗。用药14天后，患者发现面部和双手皮肤比之前变黑，遂停药，3周后皮肤色素沉着基本消退。这提示我们伏立康唑会引起光敏反应，进而导致皮肤色素沉着，使用伏立康唑的患者应该尽量避免日光照射。

　　3.药物热。患者男，50岁，因「肺曲霉病」给予伏立康唑抗真菌治疗。用药7天后，患者出现发热，最高温度达38°C,遂停药。3天后患者体温降至正常，改用伊曲康唑治疗，未再出现发热。经查询，伏立康唑所致发热的发生率为5.7%，容易被忽视而造成误诊，应引起临床医师的注意。

3. Drug fever. A 50-year-old male patient was given voriconazole antifungal therapy for pulmonary aspergillosis. After 7 days of medication, the patient developed fever and the highest temperature reached 38°C, so the medication was discontinued. After 3 days, the patient's body temperature returned to normal, and itraconazole was used to treat her. No fever occurred again. After investigation, the incidence of fever caused by voriconazole was 5.7%, which was easily overlooked and misdiagnosed, and should be paid attention to by clinicians.