肾病综合征患者他克莫司血药浓度影响因素分析  

Analysis of influence factors of tacrolimus concentration in patients with nephrotic syndrome

作　　者：计建军[1] 王长江[1] 查丽 王小琴[1] 徐佳禛 陶静[1] JI Jian-jun;WANG Chang-jiang;ZHA Li;WANG Xiao-qin;XU Jia-zhen;TAO Jing(Department of Pharmacy,the Second.Hospital Affiliated to Jiaxing University,Jiaxing 314000,China)

机构地区：[1]嘉兴学院附属第二医院药学部,浙江嘉兴314000

出　　处：《中国药物应用与监测》2022年第6期371-375,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的:通过统计分析肾病综合征患者他克莫司血药浓度的监测结果,探讨其影响因素,为肾病综合征患者合理应用他克莫司提供参考。方法:以133例肾病综合征患者为研究对象,统计分析患者性别、年龄、服药剂量、合并用药、血肌酐水平等对他克莫司血药浓度的影响。结果:日剂量>4.0 mg组女性患者平均血药浓度大于男性患者(P<0.05);日剂量≤2.0 mg和2.1~4.0 mg的不同年龄组间血药浓度差异具有统计学意义(P<0.05);对患者进行单因素分析合并多因素Logistic回归模型分析,结果显示血肌酐水平偏高(OR=10.077,95%CI:1.109~91.526)对他克莫司的血药浓度具有显著影响(P<0.05)。结论:肾病综合征患者他克莫司血药浓度个体差异大、影响因素多,建议临床用药时应遵循个体化用药原则,对患者各项临床指标进行综合分析,实现他克莫司最佳的治疗效果。Objective:To explore the influence factors of the concentration of tacrolimus in patients with nephrotic syndrome(NS)by statistically analyzed the results of tacrolimus concentration in patients with NS in order to provide references for the rational use of tacrolimus.Methods:A total of 133 patients with NS were selected,based on which the influence of gender,age,dose of tacrolimus,concomitant medication,and serum creatinine on the blood concentration of tacrolimus was analyzed.Results:The average blood concentration of tacrolimus in female patients in the group with the daily dose>4.0 mg was significantly higher than that of male patients(P<0.05).And there were significant differences in the concentration of tacrolimus among different age groups with dose≤2.0 mg and 2.1–4.0 mg(P<0.05).Univariate analysis and multivariate Logistic regression results showed that high level of serum creatinine had a significant effect on the blood concentration of tacrolimus(OR=10.077,95%CI:1.109–91.526,P<0.05).Conclusion:The blood concentration of tacrolimus in patients with NS varied greatly in different individuals and was affected by many factors,which indicated that the principle of individualized medication should be followed and the clinical indicators of patients should be comprehensively analyzed for the best therapeutic effect during the use of tacrolimus.

关 键 词：肾病综合征 他克莫司 血药浓度 影响因素 

分 类 号：R969.3[医药卫生—药理学] R979.5[医药卫生—药学]