目标浓度干预概况及研究进展  

Overviews and Advances in Studies of Target Concentration Intervention

作　　者：凌静[1] 焦正[1] 钟明康[1] 

机构地区：[1]复旦大学附属华山医院药剂科,上海200040

出　　处：《中国药学杂志》2013年第16期1337-1342,共6页Chinese Pharmaceutical Journal

摘　　要：目的综述目标浓度干预(target concentration intervention,TCI)理论,为临床个体化给药提供依据。方法查阅国内外相关文献和实践案例,进行分析、归纳、总结及评述。结果 20世纪60年代,治疗药物监测(therapeutic drug monitoring,TDM)进入临床实践,并协助个体化用药。但随着治疗药物监测实践的发展,逐渐显现出一些局限性,如忽视个体间变异及药效,因此不能达到安全有效使用药物的目的。目标浓度干预理论利用患者和疾病的所有相关信息,综合药动学、药效学原理,可分析和解释体内药物浓度和药物效应之间的关系及相关影响因素,克服了治疗药物监测的缺陷,为个体化给药提供了一个完整的方法和策略。结论目标浓度干预理论是在治疗药物监测基础上的进一步延伸与发展,对临床个体化给药具有重要意义。OBJECTIVE To review the target concentration intervention （TCI） theory and provide reliable evidences for the optimization of drug treatment in clinical practice. METHODS Relevant literatures were extensively and comprehensively reviewed. RESULTS Since 1960s, therapeutic drug monitoring （TDM） had been applied in clinical practice to realize individualized drug administration. Due to some potential limitations of TDM such as neglecting inter-individual variability and failure to take drug effects into ac- count, more and more scholars proposed a new theory which is called TCI as an alternative of TDM. The TCI approach takes advantage of known patient variables, pharmacokinetics and pharmacodynamics to interpret drug effect and concentration observations. It not only overcomes the defects of TDM, but also provides a complete strategy for individual administration. CONCLUSION TCI is an extension of TDM, which has clinical significance for individualized therapy.

关 键 词：目标浓度干预 变异 治疗药物监测 药动学 药效动力学 个体化治疗 

分 类 号：R969[医药卫生—药理学]