肾移植患者术后免疫抑制治疗中的吗替麦考酚酯药物暴露分析

发布时间：2018-03-21 11:09

  本文选题：吗替麦考酚酯　切入点：治疗药物监测　出处：《中国药学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的分析肾移植患者术后免疫抑制治疗的吗替麦考酚酯药物暴露个体体征,评价开展治疗药物监测必要性。方法纳入97例肾移植术后免疫抑制治疗患者,分析霉酚酸血浆浓度谷值为药物暴露标志的特征,参考国内外推荐治疗药物暴露靶值1~3.5μg·mL~(-1),评估个体化治疗必要性。统计分析运用SPSS20.0,就监测数据状态做正态分布图,采用完全随机设计的单因素方差分析不同条件下的监测结果。结果监测总样本及不同因素下样本的霉酚酸暴露数据状态符合正态分布,总样本计526例次的血药浓度(2.51±1.79)μg·mL~(-1),其中332例次达到推荐靶值范围,平均血药浓度为(2.08±0.71)μg·mL~(-1),达标率为63.0%。不同因素下状态比较:男女两组间血药浓度无统计学差异(P0.05);中青年(18~64岁)组和老年(65~77岁)组间血药浓度有统计学差异(P0.05);不同给药剂量组两两进行比较,血药浓度无统计学差异(P0.05)。不同给药方案的影响,MMF+CsA+Pre和MMF+FK506+Pre组、MMF+CsA组和MMF+FK506组、MMF+FK506+Pre组和MMF+CsA组、MMF+CsA+Pre组和MMF+FK506组分别对比,血药浓度有统计学差异(P0.05)。结论吗替麦考酚酯临床治疗个体差异较大,影响药物暴露的因素涉及年龄、剂量和合并用药等,有必要实施治疗药物监测,进行个体化治疗。
[Abstract]:Objective to analyze the individual signs of mycophenolate mofetil drug exposure in renal transplantation patients after immunosuppressive therapy and evaluate the necessity of drug monitoring. Methods 97 patients with immunosuppressive therapy after renal transplantation were included in this study. The characteristics of mycophenolic acid plasma concentration valley as a marker of drug exposure were analyzed, and the necessity of individualized treatment was evaluated by referring to the target value of drug exposure of 1 ~ 3.5 渭 g 路mL ~ (-1) at home and abroad. SPSS 20.0 was used to make a normal distribution map of the monitored data. The monitoring results under different conditions were analyzed by using a completely random design of single factor ANOVA. Results the data state of mycophenolic acid exposure in the total sample and the sample under different factors was in accordance with the normal distribution. The total blood drug concentration of 526 cases was 2.51 卤1.79 渭 g 路mL ~ (-1), of which 332 cases reached the recommended target range. The average blood drug concentration was 2.08 卤0.71 渭 g 路mL ~ (-1), and the rate of reaching the standard was 63.0. Under different conditions, there was no significant difference in blood drug concentration between male and female groups (P 0.05A; aged 1864 years) and the aged group (65 ~ 777 years). There was a significant difference in blood drug concentration between the two groups. The two groups were compared. There was no significant difference in serum drug concentration (P 0.05). The effects of different administration regimens were compared between MMF CsA Pre and MMF FK506 Pre group, MMF CsA group, MMF FK506 group, MMF CsA Pre group and MMF FK506 group, respectively. Conclusion the individual difference of clinical treatment with matimefen is significant. The factors affecting drug exposure include age, dosage and combination of drugs, so it is necessary to carry out therapeutic drug monitoring and individualized treatment.
【作者单位】： 中日友好医院药学部;北京大学药学院临床药学与药事管理学系;
【分类号】：R699.2
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