410例次肾移植患者西罗莫司血药浓度监测与不良反应分析

发布时间：2018-02-12 05:09

本文关键词： 西罗莫司肾移植血药浓度监测不良反应　出处：《中国药学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的通过监测分析服用西罗莫司肾移植患者的全血血药浓度,为肾移植患者合理用药提供指导。方法以郑州大学第一附属医院2013年1月到2015年3月共42例(共410例次)患者监测结果进行比较分析,用化学发光微粒子免疫检测法(CMIA)进行测定西罗莫司血药浓度。结果在410例次血药浓度监测中,西罗莫司血药浓度为(5.6±2.9)ng·mL~(-1),1.02~22.85 ng·mL~(-1),其中血药浓度4~8 ng·mL~(-1)的为306例次,占74.6%;小于4 ng·mL~(-1)的为46例次,占11.2%;大于8 ng·mL~(-1)的为58例次,占14.2%。血药浓度与谷丙转氨酶,谷草转氨酶,总胆固醇,甘油三酯呈正相关(P0.05);与血小板数呈负相关(r=-0.231,P0.05)。结论西罗莫司治疗窗窄,个体差异大,用药应该遵循个体化给药方案,从而提高临床疗效,减少不良反应的发生。用药时应密切关注血药浓度,及时调整剂量,并严密检测患者血脂情况。
[Abstract]:Objective to monitor and analyze the whole blood drug concentration in patients with sirolimus renal transplantation. Methods 42 patients (410 times) in the first affiliated Hospital of Zhengzhou University from January 2013 to March 2015 were compared and analyzed. Results the plasma concentration of sirolimus was 5.6 卤2.9 ng 路mL ~ (-1) ~ (-1) in 410 blood samples. The plasma concentration of sirolimus was 22.85 ng 路mL ~ (-1) (48 ng 路mL ~ (-1)), and the concentration of sirolimus was 48 ng 路mL ~ (-1). Accounting for 74.6 times; less than 4 ng 路mL ~ (-1) for 46 cases, accounting for 11.2 times; > 8 ng 路mL ~ (-1) for 58 cases, accounting for 14.2.The blood concentration and alanine aminotransferase, aspartate aminotransferase, total cholesterol, There was a positive correlation between triglyceride and platelet count, and a negative correlation between triglyceride and platelet count. Conclusion sirolimus has a narrow window and great individual difference. To reduce the incidence of adverse reactions, we should pay close attention to the concentration of blood drug, adjust the dosage in time, and closely detect the blood lipid of patients.
【作者单位】：郑州大学第一附属医院;
【分类号】：R969

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