本文選題：嗎替麥考酚酯　切入點(diǎn)：治療藥物監(jiān)測(cè)　出處：《中國(guó)藥學(xué)雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的分析腎移植患者術(shù)后免疫抑制治療的嗎替麥考酚酯藥物暴露個(gè)體體征,評(píng)價(jià)開(kāi)展治療藥物監(jiān)測(cè)必要性。方法納入97例腎移植術(shù)后免疫抑制治療患者,分析霉酚酸血漿濃度谷值為藥物暴露標(biāo)志的特征,參考國(guó)內(nèi)外推薦治療藥物暴露靶值1~3.5μg·mL~(-1),評(píng)估個(gè)體化治療必要性。統(tǒng)計(jì)分析運(yùn)用SPSS20.0,就監(jiān)測(cè)數(shù)據(jù)狀態(tài)做正態(tài)分布圖,采用完全隨機(jī)設(shè)計(jì)的單因素方差分析不同條件下的監(jiān)測(cè)結(jié)果。結(jié)果監(jiān)測(cè)總樣本及不同因素下樣本的霉酚酸暴露數(shù)據(jù)狀態(tài)符合正態(tài)分布,總樣本計(jì)526例次的血藥濃度(2.51±1.79)μg·mL~(-1),其中332例次達(dá)到推薦靶值范圍,平均血藥濃度為(2.08±0.71)μg·mL~(-1),達(dá)標(biāo)率為63.0%。不同因素下?tīng)顟B(tài)比較:男女兩組間血藥濃度無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);中青年(18~64歲)組和老年(65~77歲)組間血藥濃度有統(tǒng)計(jì)學(xué)差異(P0.05);不同給藥劑量組兩兩進(jìn)行比較,血藥濃度無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。不同給藥方案的影響,MMF+CsA+Pre和MMF+FK506+Pre組、MMF+CsA組和MMF+FK506組、MMF+FK506+Pre組和MMF+CsA組、MMF+CsA+Pre組和MMF+FK506組分別對(duì)比,血藥濃度有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論嗎替麥考酚酯臨床治療個(gè)體差異較大,影響藥物暴露的因素涉及年齡、劑量和合并用藥等,有必要實(shí)施治療藥物監(jiān)測(cè),進(jìn)行個(gè)體化治療。
[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 鹵1.79 渭 g 路mL ~ (-1), of which 332 cases reached the recommended target range. The average blood drug concentration was 2.08 鹵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.
【作者單位】： 中日友好醫(yī)院藥學(xué)部;北京大學(xué)藥學(xué)院臨床藥學(xué)與藥事管理學(xué)系;
【分類號(hào)】：R699.2
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本文編號(hào)：1643584