有限采样法估算天疱疮患者霉酚酸AUC模型的建立

发布时间：2018-06-06 14:09

本文选题：天疱疮 + 霉酚酸　；参考：《四川大学学报(医学版)》2015年04期

【摘要】：目的建立有限采样法估算天疱疮患者口服强的松联合霉酚酸酯(MMF)的霉酚酸(MPA)血药浓度-时间曲线下面积(AUC)模型。方法采集天疱疮患者口服强的松联合MMF达稳态后服药前和服药后0.5h、1h、2h、4h、6h、8h和12h外周静脉血,用酶放大免疫测定技术(EMIT)检测血浆MPA浓度,用线性梯形法计算服药后0~12h的MPA-AUC,用DAS软件分析药动学参数,用SPSS软件拟合估算MPA-AUC0-12h的回归方程,并用Bland-Altman法对其精准性进行评价。结果取得37次完整采血点数据,其MPA血药浓度-时间曲线形态基本相同;2点和3点拟合的复相关系数较低,4点、5点拟合的复相关系数较高,其中4点(1h、4h、8h、12h)、5点(0.5h、1h、4h、8h、12h)、5点(1h、4h、6h、8h、12h)拟合的回归方程与实际AUC0-12h的相关性好、误差低,结合预测精准性、检测成本和可操作性,推荐4点的回归模型AUC0-12h=7.277+1.090C1h+4.670C4h+3.214C8h+2.118C12h。结论天疱疮患者口服强的松联合多剂MMF,以服药后1h、4h、8h、12h的MPA浓度估算MPAAUC0-12h较好,可作为临床监测MPA浓度的指标,指导个体化给药。
[Abstract]:Objective to establish a limited sampling method for estimating the area under the plasma concentration-time curve of oral prednisone combined with mycophenolate mofetil (MMF) in patients with pemphigus. Methods Peripheral venous blood samples were collected from patients with pemphigus before and after oral prednisone and MMF reached stable state and 0.5 h after treatment. Plasma MPA concentration was determined by enzyme amplified immunoassay (Elisa). The linear trapezoid method was used to calculate the MPA-AUC at 0 ~ 12h after taking medicine, the pharmacokinetic parameters were analyzed by DAS software, the regression equation of MPA-AUC0-12h was estimated by SPSS software, and its accuracy was evaluated by Bland-Altman method. Results 37 complete blood sampling points were obtained. The MPA concentration-time curve was similar in shape to 2 points and 3 points respectively. The complex correlation coefficient fitted by 4 points and 5 points was higher than that of the control group, and the correlation coefficient between the two points and three points was higher than that at 4 points and 5 points, respectively. Among them, the regression equation fitted by the regression equation of 4 points, 1 hour, 1 hour, 4 h, 8 h, 12 h, 5 points, 0. 5 h, 1 h, 4 h, 6 h, 8 h, 12 h) fitted with the actual AUC0-12h, the correlation is good, and the error is low. Combined with prediction accuracy, detection cost and maneuverability, the regression model of 4 points AUC0-12h=7.277 1.090C1h 4.670C4h 3.214C8h 2.118 C12 h is recommended. Conclusion in pemphigus patients, prednisone combined with multiple doses of MMF can be used to estimate the concentration of MPAAUC0-12h at 1h, 4h, 8h and 12h, which can be used as an index for clinical monitoring of MPA concentration and as a guide for individualized administration.
【作者单位】：四川大学华西医院皮肤性病科;四川大学华西医院实验医学科临床免疫室;
【分类号】：R758.66

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