難治性腎病綜合征患兒環(huán)孢素A血藥濃度監(jiān)測(cè)回顧性分析
本文選題:環(huán)孢素A 切入點(diǎn):治療藥物監(jiān)測(cè) 出處:《中國(guó)新藥雜志》2017年09期
【摘要】:目的:評(píng)價(jià)難治性腎病綜合征患兒環(huán)孢素A(cyclosporine A,CsA)血藥濃度的監(jiān)測(cè)和臨床用藥情況。方法:對(duì)我院使用CsA治療滿3個(gè)月的45例腎病綜合征患兒的288例/次符合入選條件的CsA血藥濃度監(jiān)測(cè)結(jié)果進(jìn)行回顧性分析。結(jié)果:45例腎病綜合征患兒共監(jiān)測(cè)血藥濃度288例/次,患兒首次監(jiān)測(cè)時(shí),CsA谷濃度以中濃度為主(50~100μg·L~(-1)),隨著監(jiān)測(cè)次數(shù)的增加,低濃度占比(50μg·L~(-1))逐漸增加。CsA日劑量和谷濃度呈顯著性正相關(guān);年齡對(duì)難治性腎病綜合征患兒CsA血藥濃度水平影響較大;合并使用地爾硫等CYP450抑制劑可明顯影響CsA的血藥濃度。結(jié)論:CsA血藥濃度受較多因素影響,臨床藥師應(yīng)對(duì)長(zhǎng)程使用CsA的患兒及家長(zhǎng)進(jìn)行用藥教育,促進(jìn)患兒堅(jiān)持進(jìn)行血藥濃度監(jiān)測(cè),以確保在安全劑量下有效治療。
[Abstract]:Objective: to evaluate the monitoring of serum concentration of cyclosporine (A(cyclosporine) and cyclosporine (CSA) in children with refractory nephrotic syndrome. Methods: 288 cases of 45 children with nephrotic syndrome were treated with CsA for 3 months. Results the blood drug concentration of 45 children with nephrotic syndrome was monitored in 288cases every time. In the first time of monitoring, the concentration of CSA was 50 渭 g / L ~ (-1). With the increase of monitoring times, the ratio of low concentration to 50 渭 g / L ~ (-1) was increased gradually, and the daily dose of CSA was positively correlated with the concentration of CSA. Age had a great influence on the serum concentration of CsA in children with refractory nephrotic syndrome, and combined use of CYP450 inhibitors such as diltiazem could significantly affect the blood concentration of CsA. Conclusion the blood concentration of CsA is affected by many factors. The clinical pharmacists should educate the children and their parents on the use of CsA for a long time, and promote the children to insist on monitoring the blood drug concentration so as to ensure the effective treatment at the safe dose.
【作者單位】: 南京醫(yī)科大學(xué)附屬兒童醫(yī)院藥學(xué)部;
【分類號(hào)】:R726.9
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