年龄对重型血友病A患儿凝血因子Ⅷ药代动力学的影响  

Effect of patient age on the pharmacokinetics of factor Ⅷ in children with severe hemophilia A

作　　者：方希敏 王春艳[1] 麦惠容[1] 王春静[1] 李长钢[1] 文飞球[1] FANG Ximin;WANG Chunyan;MAI Huirong;WANG Chunjing;LI Changgang;WEN Feiqiu(Department of Pediatric Hematology & Oncology,Shenzhen Children′s Hospital,Shenzhen 518026,China)

机构地区：[1]深圳市儿童医院儿童血液和肿瘤科,深圳518026

出　　处：《中国小儿血液与肿瘤杂志》2018年第6期293-296,306,共5页Journal of China Pediatric Blood and Cancer

基　　金：深圳市科创委资助项目(JCYJ20160429180540076);深圳市卫计委资助项目(201506052);三名工程支持项目:SZSM201512033

摘　　要：目的研究年龄对重型血友病A患儿凝血因子Ⅷ药代动力学的影响,为患者的临床用药提供指导。方法将2016年1月1日-2018年1月1日收治到深圳市儿童医院血液肿瘤科的54例重型血友病A患者按照年龄分为3组:0～6岁组、～12岁组、～18岁组,每位患者经静脉输注凝血因子Ⅷ50U/kg,在不同时间点检测患者凝血因子Ⅷ活性,分析因子Ⅷ药代动力学特点。结果 3组患儿在单次注射重组人凝血因子Ⅷ50U/kg后,药物半衰期分别是:0～6岁组为(8.4±1.4)h、～12岁组为(10.4±0.8)h、～18岁组为(11.3±1.2)h;3组的清除率分别是(5.1±1.8)mL/(h·kg)、(3. 5±1. 2)mL/(h·kg)、(3. 0±0. 9)mL/(h·kg)。结论年龄对凝血因子Ⅷ药代动力学可能存在明显影响,年龄越小,半衰期越短。提示重型血友病A患者随着年龄增加,预防给药的时间间隔可以相对延长。Objective To study the effect of patient age on the pharmacokinetics of factor Ⅷ and provide guidance for clinical use.Methods 54 patients with severe hemophilia A were divided into three groups according to age from January 1,2016 to January 1,2018 in our Department:0 to 6 years old group,~12 years old group,~18 years old group.Each patient has received recombinant human coagulation factor Ⅷ infusion intravenously at the dosage of 50 u/kg,and the factor Ⅷ activity was measured at different time points to calculate the factor Ⅷ pharmacokinetics.Results After single injection of factor Ⅷ 50u/kg,the drug half-life of the three groups was 8.4±1.4h in the 0-6 years old group,10.4±0.8h in the 12-year-old group and the 18-year old group.At 11.3±1.2h,the clearance of the three groups were 5.1±1.8 mL/h/kg,3.5±1.2 mL/h/kg,and 3.0±0.9 mL/h/kg,respectively.Conclusions Age may have a significant effect on the pharmacokinetics of factor Ⅷ.The younger the age,the shorter half-life,suggesting that the time interval for prophylactic administration may be prolonged with age in patients with severe hemophilia A.

关 键 词：凝血因子Ⅷ 药代动力学 年龄 血友病A 

分 类 号：R725.5[医药卫生—儿科]