他克莫司血药浓度监测在异基因干细胞移植患者中的应用

发布时间：2018-01-27 13:49

本文关键词： 他克莫司干细胞移植血药浓度监测用药分析　出处：《中国药房》2015年26期 　论文类型：期刊论文

【摘要】：目的:探讨异基因外周血干细胞移植(Allo-HSCT)患者他克莫司血药浓度监测结果与疗效、毒副反应及联合用药等的相关性,为他克莫司临床合理应用提供参考。方法:采用酶扩大免疫分析法对16例Allo-HSCT患者住院期间Allo-HSCT 3个月后他克莫司血药浓度进行监测,对移植物抗宿主病(GVHD)出现的情况、不良反应、联合用药情况加以分析讨论。结果:他克莫司血药浓度个体差异较大。当8 ng/ml时,GVHD发生几率增加;20 ng/ml时,患者出现糖尿、肾脏毒性等不良反应的几率增加。他克莫司对于预防和治疗GVHD的作用较好,与其他药物联用可产生相互作用。结论:他克莫司血药浓度监测在Allo-HSCT患者术后预防和治疗GVHD及减少毒副反应方面有重要的作用。Allo-HSCT 3个月后,其血药浓度维持在8~20 ng/ml之间,GVHD和不良反应出现的几率较小。
[Abstract]:Objective: to investigate the relationship between the blood concentration of tacrolimus in allogeneic peripheral blood stem cell transplantation (Allo-HSCT) patients and the efficacy, side effects and combined use of tacrolimus. Methods: enzyme expanded immunoassay was used to evaluate Allo-HSCT in 16 patients with Allo-HSCT during hospitalization. Three months later, the blood concentration of tacrolimus was monitored. The occurrence and adverse reactions of graft-versus-host disease (GV HDD) were analyzed and discussed. Results: the blood concentration of tacrolimus was significantly different at 8 ng/ml. The incidence of GVHD increased; At 20 ng/ml, the incidence of adverse reactions such as glycosuria and renal toxicity increased. Tacrolimus had a better effect on the prevention and treatment of GVHD. Interaction with other drugs. Conclusion:. Tacrolimus concentration monitoring plays an important role in the prevention and treatment of GVHD and the reduction of side effects in patients with Allo-HSCT after 3 months of Allo-HSCT. The incidence of GVHD and adverse reactions was lower when the blood concentration was maintained between 8 and 20 ng/ml.
【作者单位】：厦门大学附属中山医院;厦门大学药学院;
【分类号】：R969.1
【正文快照】： 他克莫司(普乐可复,FK506)是一个由链霉菌属微生物获得的大环内酯类抗生素,现已广泛用于各种器官移植术后的抗排斥治疗。其作用机制与环孢素相同,是通过抑制钙调磷酸酶而抑制T细胞活化。FK506属于狭窄治疗指数药物(NTI),该药的生物利用度较低,不同患者在药动学上存在很大的差

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