环孢素血药浓度监测在再生障碍性贫血治疗中的观察  

Monitoring of cyclosporine blood concentration in the treatment of aplastic anemia

作　　者：宋扬[1] 冷青[1] 季征[1] 吴音[1] 张桂敏[1] 马清君[1] 马瑀[1] 

机构地区：[1]辽宁省鞍山市中心医院血液科,辽宁鞍山114001

出　　处：《实用药物与临床》2017年第9期1058-1060,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探究环孢素A(CsA)浓度监测在再生障碍性贫血(AA)治疗中的临床意义。方法回顾性调查2011年5月至2015年5月经我院确诊为AA的患者48例,对425例次CsA血药浓度监测数据进行统计分析。结果 CsA平均血药浓度为(195.75±162.52)ng/m L,156次监测处于目标血药浓度的范围内(36.7%)。接受首次监测的患者,血药浓度结果在目标范围内16例(33.33%),22例患者的监测结果在目标范围以下(45.83%)。患者血药浓度的监测结果是否处于目标范围与年龄无相关性,差异无统计学意义(P=0.689)。所有患者在治疗期间均接受监测,总有效率为68.75%。此外,接受监测次数小于3次患者的有效率明显低于监测次数大于3次(4~10次)的患者(P=0.002)。结论 CsA的药动学个体差异大,血药浓度监测有助于提高CsA治疗AA的有效率。环孢素浓度监测在再生障碍性贫血治疗中有重要意义,及时准确地监测CSA的血药浓度,可避免或减少治疗中不良反应的发生,提高治疗效果。Objective To investigate the clinical significance of monitoring of cyclosporine A（ CsA） concentration in the treatment of aplastic anemia（ AA）. Methods A total of 48 cases of AA patients diagnosed in our hospital from May 2011 to May 2015 were chosen,and the monitoring data of blood drug concentration of 425 cases was counted and analyzed. Results The average blood concentration of CsA was（ 195. 75 ± 162. 52） ng/m L,and the 156 times of monitoring was within the range of target serum concentration（ 36. 7%）. In patients receiving first monitoring,there were 16 patients（ 33. 33%） whose serum concentrations were within the target range and 22 patients（ 45. 83%） whose serum concentration were belowtarget range. There was no correlation between the proportion of the target range and the age of the patients with blood drug concentration monitoring,and the difference was not statistically significant（ P = 0. 689）. The total effective rate was 68. 75%. In addition,the effective rate in patients receiving monitoring less than 3 times was less than that in patients with monitoring times greater than 3 times（ 4 ~ 10 times）（ P =0. 002）. Conclusion The pharmacokinetics of CsA vary greatly,and the monitoring of serum concentration can improve the efficiency of CsA in the treatment of AA. CSA concentration monitoring plays an important role in the treatment of aplastic anemia. Timely and accurate monitoring of CsA blood concentration can avoid or reduce the occurrence of adverse reactions and improve the therapeutic effect.

关 键 词：环孢素 浓度检测 再生障碍性贫血 血药浓度 

分 类 号：R556.5[医药卫生—血液循环系统疾病]