肝移植患者他克莫司谷血药浓度监测意义和临床个体化用药调节  

The Significance of Tacrolimus Blood Concentration Monitoring and Clinical Individualized Medication for Liver Transplantation Patients

作　　者：刘丽娟[1] 赖雁威 李慧云[1] 梁伟[2] 胡会英[3] 

机构地区：[1]北京大学深圳医院药剂科,广东深圳518036 [2]北京大学深圳医院肾内科,广东深圳518036 [3]北京大学深圳医院门诊部,广东深圳518036

出　　处：《现代生物医学进展》2015年第12期2281-2285,共5页Progress in Modern Biomedicine

基　　金：深圳市科技创新委员会立项项目(JCYJ20140415162338816)

摘　　要：目的:探讨移植术后监测他克莫司血药浓度意义和临床药物剂量个体化调节方法。方法:70例肝移植患者术后采用口服他克莫司,每天两次的用药方案,分别在移植后1周和3周监测血液中他克莫司浓度以及外周血单核细胞中钙调磷酸酶活性。结果:移植3周比1周时他克莫司的清除率显著提高。每个采样时间的药物浓度都与0-12 h的浓时间曲线(AUC0-12)下方的面积呈显著的正相关。钙调磷酸酶最低活性与0-12 h的钙调磷酸酶活性-时间曲线显著相关(r2>0.92)。结论:谷浓度监测是对成年生物配体原位肝移植患者常规他克莫司用药剂量调整的最佳方法,同时监测患者钙调磷酸酶最低活性有助于估计患者在他克莫司用药间隔期的免疫状况。Objective： To investigate the significance of tacrolimus blood concentration monitoring and clinical drug individual dosage adjustment method. Methods： 70 cases of liver transplantation patients had administration of tacrolimus two times daily after transplantation. Their blood concentration of tacrolimus and calcineurin activity in PBMC were monitored respectively at one week and three weeks after transplantation. Results： Acrolimus clearance rate increased significantly at three weeks compared to＇～hat at one week after transplantation. The drug concentration of each sampling time point was positively related to the area under the concentration-time curve of 0-12h （AUC0-12）. A significant correlation was also found between the lowest calcineurin activity and 0-12 h calcineurin activity time curves （r2〉0.92）. Conclusion： Concentration monitoring is the best method for adult patients with LDLT in conventional＂ taerolimus dosage adjustment. Simultaneous monitoring of calcineurin activity in patients with the lowest is helpful in estimating the immune status of patients in the tacrolimus dosing interval period.

关 键 词：肝移植 药物谷浓度 他克莫司 

分 类 号：R657.3[医药卫生—外科学] R969.1[医药卫生—临床医学]