不同给药途径下质子泵抑制药对肾移植患者免疫抑制药血药浓度的影响  

Effect of Different Administration Routes of Proton Pumps Inhibitors on Serum Levels of Immunosppressants in Kidney Transplant Recipients

作　　者：徐世希[1] 林杰[1] 李洁[1] 廖湘平[1] 邹琴[1] 周艳琴[1] Xu Shixi;Lin Jie;Li Jie;Liao Xiangping;Zou Qin;Zhou Yanqin(Chenzhou No.1 People's Hospital,Hunan Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院,湖南郴州423000

出　　处：《中国药师》2022年第11期1980-1983,共4页China Pharmacist

基　　金：湘南学院校级科学研究青年项目(编号:2021XJ48);郴州市第一人民医院院级科研项目(编号:N2019-013)。

摘　　要：目的:研究不同给药方式给予质子泵抑制药(PPIs)对肾移植术后患者吗替麦考酚酯及他克莫司血药浓度的影响。方法:利用均相酶免疫法检测肾移植患者口服及静脉给予PPIs时,吗替麦考酚酯及他克莫司的血药浓度。分析两种给药方式对吗替麦考酚酯及他克莫司血药浓度的影响。结果:与静脉给予PPIs时相比,口服给予PPIs时霉酚酸(MPA)的谷浓度(C_(0))平均升高1.36倍,给药后30 min的血浓度(C_(30)平均升高1.48倍,120 min药时曲线下面积(AUC_(0-120))平均升高1.17倍,他克莫司谷浓度平均升高1.54倍,差异均有统计学意义(P<0.05)。MPA给药后120 min的血浓度(C_(120))平均升高了1.04倍,但差异无统计学意义(P>0.05)。静脉给予PPIs时他克莫司谷浓度达标率为24.39%,而口服给予时为85.36%,差异有统计学意义(P<0.01)。结论:临床药师监测血药浓度对肾移植术后患者进行药学监护,吗替麦考酚酯的血药浓度和他克莫司的血药浓度达标率均有明显提高,在临床药物治疗过程中起到了重要作用。Objective:To study the effect of different administration routes of proton pumps inhibitors(PPIs)on the serum levels of mycophenolate mofetil(MMF)and tacrolimus(TAC)in kidney transplant recipients.Methods:Homogeneous enzyme immunoassay was used to detect the serum concentrations of MMF and TAC co-adminstrated with oral pantoprazole and intravenous pantoprazole in kidney transplant patients,and the effect of the two administration routes on the serum concentrations of MMF and TAC was analyzed.Results:Compared with intravenous PPI,C_(0) of mycophenolic acid(MPA)was increased by an average of 1.36 times for oral PPI,C_(30) was increased by 1.48 times,AUC_(0-120)was increased by 1.17 times,the concentration of TAC valley concentration was increased by 1.54 times,and the difference was statistically significant(P<0.05).Compared with intravenous PPI,C_(120)of MPA was increased by an average of 1.04 times for oral PPI,while the difference was not statistically significant(P>0.05).The TAC trough concentration compliance rate was increased from 24.39%when PPI was given intravenously to 85.36%when PPI was administered orally,and the difference was statistically significant(P<0.01).Conclusion:By monitoring the blood drug concentration,clinical pharmacists play an important role in the clinical drug treatment of patients after kidney transplantation,which can improve the standard reaching rates of blood drug concentrations of MMF and TAC.

关 键 词：吗替麦考酚酯 他克莫司 口服 血药浓度监测 临床药师 

分 类 号：R969.1[医药卫生—药理学]