难治性肾病综合征患儿环孢素A血药浓度监测回顾性分析  

Retrospective analysis of cyclosporine A blood concentration monitoring in children with refractory nephrotic syndrome

作　　者：刘瑶[1] 景霞[1] 孙芳[1] 许泽君[1] 许静[1] 

机构地区：[1]南京医科大学附属儿童医院药学部,南京210008

出　　处：《中国新药杂志》2017年第9期1093-1096,共4页Chinese Journal of New Drugs

摘　　要：目的:评价难治性肾病综合征患儿环孢素A(cyclosporine A,CsA)血药浓度的监测和临床用药情况。方法:对我院使用CsA治疗满3个月的45例肾病综合征患儿的288例/次符合入选条件的CsA血药浓度监测结果进行回顾性分析。结果:45例肾病综合征患儿共监测血药浓度288例/次,患儿首次监测时,CsA谷浓度以中浓度为主(50~100μg·L^(-1)),随着监测次数的增加,低浓度占比(<50μg·L^(-1))逐渐增加。CsA日剂量和谷浓度呈显著性正相关;年龄对难治性肾病综合征患儿CsA血药浓度水平影响较大;合并使用地尔硫等CYP450抑制剂可明显影响CsA的血药浓度。结论:CsA血药浓度受较多因素影响,临床药师应对长程使用CsA的患儿及家长进行用药教育,促进患儿坚持进行血药浓度监测,以确保在安全剂量下有效治疗。Objective： To evaluate the therapeutic drug monitoring （TDM） and the clinical drug utilization of cyclosporine A （CsA） in refractory nephrotic syndrome （RNS） children patients. Methods： The data of 288 cases was collected from 45 patients and was retrospectively analyzed. Results： Among the first monitoring, most CsA concentrations were in middle levels between 50 -100 μg·L^-1. With the treatment continuing, the proportion of low level increased. In our study, trough concentration of CsA was positively corelated with the dose of CsA. Furthermore, the age of children and the dose of dihiazem, the inhibitor of CYP450, also showed significant impacts on the level of CsA concentrations. Conclusion： The level of CsA concentration was affected by many factors. The clinical pharmacists should persuade the children patients to keep on monitoring the CsA concentrations to make sure the effective treatment with safe dose rigemen.

关 键 词：环孢素A 治疗药物监测 难治性肾病综合征 

分 类 号：R979.5[医药卫生—药品]