肾病综合征患儿他克莫司血药谷浓度监测结果分析  

Analysis of Monitoring Results of Tacrolimus Blood Trough Concentration in Children with Nephrotic Syndrome

作　　者：陈军校 李娜 CHEN Jun-xiao;LI Na(Xianyang Hospital of Yan'an University,Xianyang Shaanxi 712000)

机构地区：[1]延安大学咸阳医院,陕西咸阳712000 [2]咸阳市妇幼保健院,陕西咸阳712000

出　　处：《医学临床研究》2022年第10期1463-1465,1470,共4页Journal of Clinical Research

摘　　要：【目的】分析肾病综合征(NS)患儿他克莫司血药谷浓度监测结果及其临床指导意义。【方法】选取97例NS患儿作为研究对象,患儿均接受他克莫司治疗,并记录其用药情况。分析患儿性别、年龄、给药剂量与不同血药谷浓度的分布情况,统计患儿治疗效果,观察不同疗效患儿他克莫司血药谷浓度变化及不良反应发生情况,应用Spearman相关性分析患儿他克莫司血药谷浓度与治疗疗效的相关性。【结果】不同血药谷浓度患儿性别、年龄分布比较,差异无统计学意义(P>0.05);临床给药剂量比较,差异有统计学意义(P<0.05)。97例NS患儿经治疗后,完全缓解(CR)患儿32例(32.99%),部分缓解(PR)患儿41例(42.27%),未缓解(NR)患儿24例(24.74%)。不同疗效患儿第1周、第2周、第3周他克莫司血药谷浓度比较,差异有统计学意义(P<0.05);CR患儿第1周、第2周、第3周他克莫司血药谷浓度均高于PR、NR患儿,且PR患儿高于NR患儿(P<0.05)。CR患儿不良反应发生率为53.12%,PR患儿为51.22%,NR患儿为33.33%,不同疗效患儿不良反应发生率比较,差异无统计学意义(P>0.05)。Spearman相关分析显示,NS患儿治疗疗效与他克莫司血药谷浓度存在正相关(rs=0.842)。【结论】NS患儿性别、年龄对他克莫司血药谷浓度影响较小,而他克莫司给药剂量可在一定程度上影响其血药谷浓度,临床要合理降低药物带来的不良反应,需制定适宜的他克莫司血用药剂量,提升治疗安全性。【Objective】To analyze the monitoring results of tacrolimus blood trough concentration in children with nephrotic syndrome(NS)and its guiding significance.【Methods】A total of 97 children with nephrotic syndrome were selected as the study object.All the children were treated with tacrolimus,and their drug use was recorded.Their gender,age,dosage and distribution of different blood trough concentrations were analyzed.Their treatment effects were statistically analyzed.The changes of blood trough concentrations of tacrolimus and adverse reactions in children with different therapeutic effects were observed,Spearman correlation analysis was used to explore the correlation between the blood trough concentration of tacrolimus and the therapeutic effect in children.【Results】There was no significant difference in gender and age distribution of children with different blood drug concentration(P>0.05);The difference in clinical dosage was statistically significant(P<0.05).After treatment in 97 children with NS,there were 32 patients with CR(32.99%),41 patients with PR(42.27%),and 24 patients with NR(24.74%).There was a statistically significant difference in the blood concentration of tacrolimus in the first,second and third weeks of children with different therapeutic effects(P<0.05);The trough concentration of tacrolimus in children with CR at week 1,2 and 3 was higher than that in children with PR and NR,and that in children with PR was higher than that in children with NR(P<0.05).The incidence of adverse reactions in children with CR was 53.12%,that in children with PR was 51.22%,and that in children with NR was 33.33%.There was no significant difference in the incidence of adverse reactions in children with different therapeutic effects(P>0.05).Spearman correlation analysis showed that there was a positive correlation between the therapeutic effect of NS children and the blood trough concentration of tacrolimus(rs=0.842).【Conclusion】The sex and age of children with nephrotic syndrome have little influen

关 键 词：肾病综合征 他罗利姆/类似物和衍生物 血药浓度 

分 类 号：R692[医药卫生—泌尿科学]