肝移植术后环孢素治疗药物监测  

Therapeutic drug monitoring of cyclosporine in patients with liver transplantation

作　　者：孙增先[1] 张骞峰[1] 周金玉[1] 葛旭明[1] 杨致富[1] 

机构地区：[1]连云港市第一人民医院临床药学研究中心,江苏连云港222002

出　　处：《中国医院药学杂志》2006年第1期40-42,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:研究肝移植受者环孢素A临床药动学特点,优化环孢素A治疗药物监测方案。方法:采用荧光偏振免疫法测定环孢素A血药浓度,计算临床药动学参数。建立AUC0-12h与浓度变量回归模型。对C0、C2常规监测数据进行分析。结果:环孢素代谢呈二房室开放模型。C0+C2与AUC0-12h相关较为强烈,C2与AUC0-4h和AUC0-12h的相关性高于C0。在估算AUC0→12h的回归模型中,C0+C2最好,SE和R-sq分别为501.0和94.7,其后是C6,C2,C9,C4和C0。结论:环孢素A临床药动学个体差异大。C0+C2两点监测是环孢素A最好的监测方法,可客观评价环孢素A体内药物暴露(AUC0-12h),减少急性排斥和药物中毒发生。C2/C0可以作为评价移植肝功能恢复的灵敏指标。OBJECTIVE To study clinical phmanacokinetics of cyclosporine A in liver transplant recipients and optimize cyclosporine A therapeutic drug monitoring strategy. METHODS The whole blood concentrations of cyclosporine A were measured by fluorescence polarization itrununoassay （FPIA） , clinical pharmacokinetics parameters of cyclosporine A were computed. While blood cyclosporine A concentrations being independent variable, AUC0-12h, regression models were established. Routine monitoring data of C0 and C2 were analysed. RESULTS Cyclosporine A metabolizability were a linear two-compartment model with first-order absorption. There was strong correlation between C0 ＋C2 and AUC0-12h, and the correlation between C2 and AUC0 -4h or AUC0-12h was both more excellent than C0. In regression models for calculating AUC0-12h, C0 ＋ C2 single complex variable was the best, SE and R - sq were 501.02 and 94.7, respectively. Next was C6, C2, C9, C4, C0. CONCLUSION Clinical pharmacokinetics of cyclosporine A was greatly different among patients. C0 ＋ C2 of two point monitoring was the best monitoring method for cyclosporine A . It can evaluate impersonally cydosporine exposure （AUC0-12h） in body and decrease rejection and drug toxicity. C2/C0 was a sensitive indication to.evaluate function restoriation of the transplant liver.

关 键 词：肝移植 环孢素A 治疗 药物监测 药动学 

分 类 号：R969[医药卫生—药理学]