某院他克莫司治疗肾病综合征的用药效果评价  

Evaluation of clinical efficacy of tacrolimus in treatment of nephritic syndrome in a hospital

作　　者：朱旭[1] 路童 庞露[1] 刘立民[1] 肇丽梅[1] ZHU Xu;LU Tong;PANG Lu;LIU Li-min;ZHAO Li-mei(Department of Pharmacy, Shengjing Hospital of China Medical University, Liaoning Shenyang 110004, China;School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Liaoning Shenyang 110016, China)

机构地区：[1]中国医科大学附属盛京医院药学部,辽宁沈阳110004 [2]沈阳药科大学生命科学与生物制药学院,辽宁沈阳110016

出　　处：《中国医院药学杂志》2018年第22期2348-2351,共4页Chinese Journal of Hospital Pharmacy

基　　金：辽宁省教育厅科学技术研究项目(编号:LK201611);国家自然科学基金资助项目(编号:81673510)

摘　　要：目的:通过分析他克莫司血药浓度以及用药情况,评价他克莫司治疗肾病综合征患者的临床疗效及不良反应。方法:收集于某院治疗的40例服用他克莫司治疗肾病综合征患者,定期监测他克莫司全血谷浓度,观察24h尿蛋白、血清白蛋白、肾功能等病理生理指标变化。结果:40例患者经治疗1个月后24h尿蛋白已明显下降,3个月后血清白蛋白水平显著提高。治疗6个月后,完全缓解率、部分缓解率、未缓解率及复发率分别为20.0%,50.0%,20.0%和10.0%;未缓解患者标准化血药浓度显著升高。治疗期间,2例患者出现腹泻,6例患者血糖升高,2例出现手部震颤,8例出现肌酐升高。结论:他克莫司治疗肾病综合征可快速缓解临床症状,长期用药需定期评估疗效,并及时监测不良反应,以保证用药安全和有效。OBJECTIVE To evaluate clinical efficacy and adverse reactions of tacrolimus by analyzing whole blood concentration and drug usage.METHODS Data of tacrolimus usage were collected in 40 patients with nephrotic syndrome in our hospital.Whole blood concentration of tacrolimus was monitored regularly.The changes of physical and pathologic indexes were observed including 24-hour urinary protein,serum albumin,renal function,etc.RESULTS 24-hour urinary protein was significantly decreased after 1 month of treatment in 40 patients and serum albumin levels increased significantly after 3 month of treatment.Moreover,after 6 months of treatment,the complete remission rate,partial remission rate,no remission rate and relapse rate were 20.0%,50.0%,20.0%and 10.0%,respectively.The dose adjustment concentrations of tacrolimus were significantly increased in no remission patients.During the treatment,2 patients had diarrhea,6 patients had elevated blood glucose,2 patients experienced hand tremor,and 8 cases showed increased serum creatinine.CONCLUSION Tacrolimus can rapidly relieve clinical symptoms for nephrotic syndrome.Clinical efficacy needs to be regularly evaluated with long term medication,and adverse reactions are monitored in a timely manner.These can help to ensure the safety and efficacy of tacrolimus.

关 键 词：他克莫司 疗效 不良反应 血药浓度 肾病综合征 

分 类 号：R96[医药卫生—药理学]