肾移植患者中麦考酚酸游离分数的影响因素  

Investigation of the factors affecting the unbound fraction of mycophenolic acid in renal transplant recipients

作　　者：仲珑瑾[1] 焦正[1] 梁惠琪[1] 沈杰[2] 钟建泳[2] 张明[2] 钟明康[1] 

机构地区：[1]复旦大学附属华山医院,上海200040 [2]上海华东医院,上海200040

出　　处：《中国医院药学杂志》2006年第6期669-672,共4页Chinese Journal of Hospital Pharmacy

基　　金：上海市自然科学基金课题(编号:03ZR14010);上海市卫生局百人计划Ⅱ期资助项目(98BR009)

摘　　要：目的:探讨肾移植患者中影响麦考酚酸(MPA)游离分数的因素。方法:采集23名肾移植术后3个月内患者12h内11个时间点的血浆样本,HPLC法测定血浆中游离和总的MPA及其代谢物葡萄糖醛酸结合物(MPAG)浓度。多元线性回归法考察受试者生理、病理特征和MPA游离分数(FUMPA)的相关性。结果:MPA游离分数的自然对数[ln(FUMPA)]与白蛋白(ALB),血红蛋白的自然对数[ln(Hb)]呈负相关,与MPA游离浓度AUC(MPAfAUC0-12),MPAG的游离分数(FUMPAG)呈正相关,相关系数r分别为-0.552,-0.459,0.781和0.458;P值分别为0.006,0.028,0.000和0.028。其关系式为:ln(FUMPA)=-0.055 4(ALB)-1.924,r=-0.552;ln(FUMPA)=1.128MPAf+2.181FUMPAG-5.171,r=-0.850。结论:ALB升高,可致FUMPA呈指数增加;MPAG可与MPA竞争性结合蛋白。OBJECrIVE To investigate the factors affecting the unbound fraction of mycophenolic acid （MPA） in renal transplant recipients. METHODS The blood samples of renal transplant recipients in their early post-renal-transplant period （the first 3 months） were collected within 12 h. The total and free plasma concentration of MPA and its glucuronide （MPAG） was determined by HPLC method. Correlations between the unbound fraction of MPA （FUMPA） and the physiology and pathology characteristics of the renal transplant recipients were determined using multiple regression. RESULTS The natural logarithm of FUMPA （In FUMPA） was negatively correlated with albumin （ALB） and the natural logarithm of hemoglobin （In Hb）, while In FUMPA was positively correlated with the AUC of free MPA （MPAf AUG0-12 ） and the unbound fraction of MPAG （FUMPAG）. The correlation coefficient （r） was -0. 552, -0. 459,0. 781 and 0. 458, respectively and the P value was 0. 006, 0. 028,0. 000 and 0. 028,respectively. The regression equations were ln（FUMPA ） = - 0. 0554（ALB） - 1. 924, r = - 0. 552; In （FUMPA） = 1. 128 MPAf ＋ 2. 181 FUMPAG - 5. 171, r = -0. 851）. CONCLUSION The FUMPA exponentially increased in association with increases in ALB,and MPAG would competitive bind the protein with MPA.

关 键 词：麦考酚酸 麦考酚酸葡糖苷酸 游离分数 相关性分析 

分 类 号：R969[医药卫生—药理学]