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出 处:《中华医学杂志》2009年第4期251-253,共3页National Medical Journal of China
摘 要:目的通过对64例接受初次同种异体肾脏移植的患者进行霉酚酸酯(MMF)药代动力学的描述性研究,揭示霉酚酸(MPA)体内的代谢特点及其与临床效应的关系。方法对患者进行MPA服药前浓度(MPA-C0)定期测定并随访观察临床效应。结果无毒副反应及无急性排斥组的MPA-C。中位数为0.74mg/L,发生MMF相关毒副反应组MPA-C。中位数为1.32mg/L,急性排斥组MPA-C。中位数为0.39mg/L,3组间差异均有统计学意义(均P〈0.05)。结论研究提示MPA-C。是较为合适的临床药代动力学监测指标。Objective To investigate the correlation of pharmacokinetic profiles of mycophenolic acid (MPA) with clinic events in kidney transplant patients treated with mycophenolate mofetil (MMF). Methods Sixty-four kidney transplant patients were treated with the triple immune suppression protocol with cyclosporine, MMF, and prednisone. Before the administration of drugs, and 0. 5, 1, 1.5, 2, 2. 5, 4, 6, 8, 10, and 12 hours after the drug administration peripheral blood samples were collected to detect the plasma MPA concentrations (MPA-C0) and draw the concentration-time curve. And 4, 7, 21, and 28 days, and 1.5, 2, 3, and 6 months later peripheral blood samples were collected in the morning before drug administration so as to dynamically measure the plasma MPA concentrations. Clinical events were observed. Results No side effect or acute rejection episode occurred with the median MPA-Co value of 0. 74 mg/L. Side effects occurred with the median MPA-C0 value of 1.32 mg/L. Sixteen case-times demonstrated acute rejection episode with the median MPA-C0 value of 0. 39 mg/L. The incidence rates of different side effects, such as infection, bone marrow depression, and digestive tract symptoms were significantly related to MPA-C0 dose-dependently. Conehtsion MPA-C0 may be an appropriate pharmacokinetic monitoring parameter for kidney transplant.
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