膜性肾病患者他克莫司血浓度与给药剂量的相关性研究  

Correlation between Plasma Concentration and Dose of Tacrolimus in the Treatment of Membranous Nephropathy

作　　者：刘晓霞[1] 叶冬梅[1] 兰顺[1] 

机构地区：[1]广西壮族自治区人民医院药学部,南宁530021

出　　处：《中国药师》2015年第5期784-786,共3页China Pharmacist

基　　金：广西医疗卫生重点科研课题(编号:桂卫重2012105);广西壮族自治区卫生厅计划课题(编号:桂卫自2013351)

摘　　要：目的：研究他克莫司治疗膜性肾病的有效血药浓度与给药剂量的相关性。方法：41例膜性肾病患者给予他克莫司联合小剂量激素治疗,采用均相酶扩大免疫分析法测定他克莫司全血谷浓度,根据患者24h尿蛋白、血浆白蛋白及肾功能变化进行临床疗效评价,分析他克莫司治疗膜性肾病的疗效与血药浓度及给药剂量的相关性。结果：完全缓解组患者他克莫司血药浓度为（7.47±2.74）ng·ml-1,给药剂量为（0.047±0.007）mg·kg-1·d-1；部分缓解组血药浓度为（5.72±1.19）ng· ml-1,给药剂量为（0.049±0.008）mg·kg-1·d-1；无缓解组血药浓度为（3.30±1.08）ng·ml-1,给药剂量为（0.052±0.01） mg·kg-1·d-1。结论：他克莫司血药浓度在（5.10~9.32）ng·ml-1时有较好治疗效果,部分患者血药浓度不随给药剂量的增加而提高。Objective：To investigate the correlation between plasma concentration and effective dose of tacrolimus in the treatment of membranous nephropathy. Methods： Totally 41 patients with membranous nephropathy were given tacrolimus combined with hor-mone at low dose. The valley plasma concentration of tacrolimus was detected using a homogeneous enzyme multiplied immunoassay method. According to the changes of 24-hour urine protein,serum albumin and kidney function, the clinical efficacy was evaluated. The correlation between curative effect and plasma concentration and dosage of tacrolimus in the treatment of membranous nephropathy was analyzed. Results：The plasma concentration of tacrolimus was （7. 47 ± 2. 74） ng·ml-1 and the dosage of administration was （0.047 ±0.007）mg·kg-1·d-1 in complete remission group, that in partial remission group respectively was （5.72 ±1.19）ng· ml-1 and（0.049 ±0.008）mg·kg-1·d-1, and that in non-remission group was respectively （3.30 ±1.08 ）ng·ml-1 and （0.052 ± 0. 01）mg·kg-1·d-1. Conclusion： The clinical efficacy of tacrolimus in the treatment of membranous nephropathy has close rela-tionship with the plasma concentration,and that is promising when the plasma concentration within the range of （5. 10-9. 32） ng· ml-1 . The plasma concentration of tacrolimus isn＆#39;t increased with the dosage increase in some patients.

关 键 词：他克莫司 膜性肾病 血药浓度 给药剂量 

分 类 号：R979.5[医药卫生—药品] R692.6[医药卫生—药学]