五酯胶囊对CYP3A5基因分型肾病综合征患儿他克莫司血药浓度的影响  

Influence of Wuzhi-capsule on blood drug concentration of tacrolimus in nephrotic syndrome children with different CYP3A5 genotypes

作　　者：孙涛[1] 史卓[1] 彭洪军[1] 夏正坤[1] 

机构地区：[1]南京军区南京总医院儿科,江苏省210002

出　　处：《江苏医药》2016年第23期2556-2558,共3页Jiangsu Medical Journal

基　　金：江苏省博士后基金(1102154C);南京军区南京总医院课题(2013009)

摘　　要：目的探讨五酯胶囊对CYP3A5基因分型肾病综合征患儿他克莫司血药浓度的影响。方法肾病综合征患儿30例,口服他克莫司0.1mg·kg^(-1)·d^(-1)诱导治疗,但血药浓度始终偏低。依CYP3A5基因分型,*1/*1型6例(A组),*1/*3型13例(B组),*3/*3型11例(C组)。加用五酯胶囊口服,每日2次。用药前和用药1周后检测患儿他克莫司血药物浓度及肝肾功能,并测定尿N-乙酰氨基葡萄糖苷酶(NAG)水平。结果服用五酯胶囊后,A、B、C组他克莫司血药浓度均较服药前升高[(6.07±0.79)ng/ml vs.(2.75±0.92)ng/ml、(8.45±1.14)ng/ml vs.(3.37±0.92)ng/ml、(10.97±2.80)ng/ml vs.(4.00±1.03)ng/ml](P<0.05或P<0.01),且C组升高较A、B组更加明显(P<0.05)。三组口服五酯胶囊前后肝肾功能相关指标及尿NAG水平比较均无统计学差异(P>0.05)。结论口服五酯胶囊对肾病综合征患儿他克莫司血药浓度有明显的提升效果,尤以CYP3A5*3/*3型患儿效果更为明显。Objective To explore the influence of Wuzhi-capsule on blood drug concentration of tacrolimus in nephrotic syndrome children with different CYP3A5 genotypes .Methods Based on different CYP3A5 genotypes ,30 children with nephrotic syndrome were divided into groups of A （＊1/＊1 type ,6 cases） ,B（＊1/＊3 type ,13 cases） and C（＊3/＊3 type ,11 cases） ,who were with lower blood tacrolimus concentration after orally taken tacrolimus 0 .1 mg-kg-1 ？d-1 .The children of three groups were orally taken Wuzhi-capsule twice per day .Blood concentrations of tacrolimus were detected .The liver and renal functions and urine level of N-acetyl amino glycosidase enzymes（NAG） were detected before and after one week treatment .Results Compared to before ,blood concentrations of tacrolimus after treated with Wuzhi-capsule in groups of A ,B and C were significantly increased [（6.07 ± 0.79） ng/ml vs .（2.75 ± 0.92） ng/ml ,（8.45 ± 1.14） ng/ml vs .（3.37 ± 0.92） ng/ml and （10.97 ± 2.80） ng/ml vs .（4.00 ± 1.03） ng/ml]（P〈0 .05 or P〈0 .01） ,which was more in group C than that in groups of A and B（P〈0 .05） .The liver and renal functions and urine level of NAG were not significantly different before and after treatment among three groups （ P〉0 .05 ） .Conclusion Wuzhi-capsule can effectively elevate blood concentration of tacrolimus in the children with nephrotic syndrome ,especially in children with CYP3A5 gene ＊3/＊3 type .

关 键 词：五酯胶囊 他克莫司 肾病综合征 

分 类 号：R969[医药卫生—药理学]