成人肾移植患者环孢素A血药浓度谷值监测回顾性分析  

Retrospective Analysis on Dynamic Monitoring of Cyclosporine A Blood Valley Concentrations in Adult Patients with Renal Transplant

作　　者：张梦怡 陈鹰[2] 杜霞 吴胜林 谢敏 李绍婷 

机构地区：[1]湖北省武汉市第五医院,湖北武汉430050 [2]中国人民解放军广州军区武汉总医院,湖北武汉430070

出　　处：《中国药业》2015年第12期80-81,共2页China Pharmaceuticals

摘　　要：目的动态监测肾移植患者环孢素A血药浓度,为临床安全、合理用药提供参考。方法回顾性分析73例成人肾移植患者1 033例次环孢素A血药浓度谷值的监测资料。结果有805例次（占77.93%）达到有效血药浓度（100~400 ng/m L）;有182例次（占17.62%）低于有效血药浓度（〈100 ng/m L）,其中64例出现急性排斥反应,根据Cs A谷浓度的监测结果及时调整给药剂量,排斥反应得以缓解;有46例次（占4.45%）超过有效血药浓度（〉400 ng/m L）,其中27例次表现为不同程度的中毒症状,如恶心、呕吐、震颤和头痛等,根据Cs A谷浓度的监测结果及时调整给药剂量,中毒症状得以缓解。结论及时监测患者Cs A谷浓度,并根据监测结果调整Cs A的给药剂量和给药时间间隔,合理制订个体化给药方案,可避免毒性反应和排斥反应的发生,提高患者用药安全性,减少不良反应的发生。Objective To dynamically monitor the blood concentrations of cyclosoprine A（CsA） in renal transplant patients to provide reference for clinical safe and rational medication. Methods The monitoring data from 1 033 cases- times of cyclosporine A blood val- ley concentration in 73 cases of adult renal transplant were performed the retrospective analysis. Results 805 case-times reached the effective blood concentration （100-400 ng/mL）, accounting for 77, 93% of the total number; 182 case- times were lower than the ef- fective blood concentration （〈 100 ng/mL）, accounting for 17.62% of the total number, including 64 case of acute rejection reaction, after timely adjusting CsA dose according to the monitoring results, the rejection reaction was alleviated; 46 case- times exceeded the effective blood concentration（〉 400 ng/mL）, accounting for 4.45% of the total number, including 27 case-times showed varying de- grees of toxic symptoms, such as nausea, vomiting, tremor and headache, the CsA dose was timely adjusted according to the monitoring results and the toxic symptoms were finally relieved. Conclusion Timely monitoring blood valley concentrations, adjusting the CsA dose and administration interval, and rationally formulating the individualized medication regimen can avoid the occurrence of toxic reactions and rejection reactions, increase the medication safety and reduce the occurrence of adverse reactions.

关 键 词：成人 肾移植 环孢素A 血药浓度 回顾性分析 

分 类 号：R969.3[医药卫生—药理学] R979.5[医药卫生—药学]