霉酚酸浓度监测对肾移植受者移植后感染的预测价值分析  

Predictive value of mycophenolic acid concentration monitoring in renal transplant recipients after transplantation

作　　者：杨青彦[1] 王长安[1] 韩健乐 李涛 杨帅平[1] YANG Qing-yan;WANG Chang-an;HAN Jian-le;LI Tao;YANG Shuai-ping(Urology Department,Zhengzhou the Seventh People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院肾移植肾内科,郑州450000

出　　处：《医药论坛杂志》2020年第11期81-84,共4页Journal of Medical Forum

摘　　要：目的评估监测霉酚酸浓度预测肾移植受者移植后感染的价值。方法选取2015年6月至2019年8月郑州市第七人民医院肾移植肾内科收治的140例肾移植患者为研究对象,其中58例发生感染(纳入观察组),82例无感染(纳入对照组),收集两组入院期间各时点(服药前、服药后30 min、2 h、4 h)MPA血药浓度资料,比较其简化药时曲线下面积(MPA-AUC0-4)、实验室检查结果。结果入院前,观察组服药后4 h MPA浓度、MPA-AUC0-4较对照组高(P<0.05),两组服药前、服药后30 min、服药后2 h MPA浓度比较差异无统计学意义(P>0.05);入院时观察组的MPA浓度有所下降,且观察组服药前MPA浓度低于对照组(P<0.05),而两组服药后30 min、2 h、4 h MPA浓度、MPA-AUC0-4比较差异无统计学意义(P>0.05);出院时,观察组各时点MPA浓度、MPA-AUC0-4与对照组比较差异无统计学意义(P>0.05)。结论监测MPA浓度能较好预测肾移植受者移植后感染风险,尤其是MPA-AUC0-4、服药后4 h MPA浓度对感染发生风险判断价值高,值得在临床推广实践。Objective To evaluate the value of mycophenolic acid in predicting the infection of transplant recipients after renal transplantation.Methods A total of 140 renal transplant patients admitted to the Department of Kidney Transplantation of the Seventh People’s Hospital of Zhengzhou from June 2015 to August 2019 were selected as subjects. Among them, 58 cases were infected(observation group) and 82 cases were not infected(control group). Collect MPA blood concentration data at each time point(before taking the drug, 30 min, 2 h, 4 h after taking the drug) at the time of admission. Compare the area under the simplified drug time curve(MPA-AUC0-4) and laboratory test results.Results Before admission, the MPA concentration and MPA-AUC0-4 were higher in the observation group than in the control group(P<0.05). There was no significant difference in MPA concentration between the two groups before administration, 30 minutes and 2 hours after taking the drug(P>0.05). The MPA concentration in the observation group decreased at admission, and the MPA concentration in the observation group was lower than that in the control group(P<0.05). There was no significant difference in MPA concentration and MPA-AUC0-4 between the two groups at 30 min, 2 h, and 4 h after taking the drug(P>0.05). At the time of discharge, there was no significant difference in MPA concentration and MPA-AUC0-4 between the observation group and the control group(P>0.05).Conclusion Monitoring the concentration of MPA can predict the risk of infection after transplantation in kidney transplant recipients, especially MPA-AUC0-4, and the MPA concentration at 4 h after taking the drug has high value in the risk of infection, which is worthy of clinical practice.

关 键 词：霉酚酸浓度 肾移植 受者 感染 预测价值 

分 类 号：R617[医药卫生—外科学]