本文選題：天皰瘡 + 霉酚酸�。� 參考：《四川大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2015年04期

【摘要】：目的建立有限采樣法估算天皰瘡患者口服強(qiáng)的松聯(lián)合霉酚酸酯(MMF)的霉酚酸(MPA)血藥濃度-時(shí)間曲線下面積(AUC)模型。方法采集天皰瘡患者口服強(qiáng)的松聯(lián)合MMF達(dá)穩(wěn)態(tài)后服藥前和服藥后0.5h、1h、2h、4h、6h、8h和12h外周靜脈血,用酶放大免疫測(cè)定技術(shù)(EMIT)檢測(cè)血漿MPA濃度,用線性梯形法計(jì)算服藥后0~12h的MPA-AUC,用DAS軟件分析藥動(dòng)學(xué)參數(shù),用SPSS軟件擬合估算MPA-AUC0-12h的回歸方程,并用Bland-Altman法對(duì)其精準(zhǔn)性進(jìn)行評(píng)價(jià)。結(jié)果取得37次完整采血點(diǎn)數(shù)據(jù),其MPA血藥濃度-時(shí)間曲線形態(tài)基本相同;2點(diǎn)和3點(diǎn)擬合的復(fù)相關(guān)系數(shù)較低,4點(diǎn)、5點(diǎn)擬合的復(fù)相關(guān)系數(shù)較高,其中4點(diǎn)(1h、4h、8h、12h)、5點(diǎn)(0.5h、1h、4h、8h、12h)、5點(diǎn)(1h、4h、6h、8h、12h)擬合的回歸方程與實(shí)際AUC0-12h的相關(guān)性好、誤差低,結(jié)合預(yù)測(cè)精準(zhǔn)性、檢測(cè)成本和可操作性,推薦4點(diǎn)的回歸模型AUC0-12h=7.277+1.090C1h+4.670C4h+3.214C8h+2.118C12h。結(jié)論天皰瘡患者口服強(qiáng)的松聯(lián)合多劑MMF,以服藥后1h、4h、8h、12h的MPA濃度估算MPAAUC0-12h較好,可作為臨床監(jiān)測(cè)MPA濃度的指標(biāo),指導(dǎo)個(gè)體化給藥。
[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.
【作者單位】： 四川大學(xué)華西醫(yī)院皮膚性病科;四川大學(xué)華西醫(yī)院實(shí)驗(yàn)醫(yī)學(xué)科臨床免疫室;
【分類號(hào)】：R758.66

【共引文獻(xiàn)】

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本文編號(hào)：1986863