目的 对重症肌无力患者他克莫司的血药浓度进行监测与影响因素分析,为临床合理用药提供参考。方法 以我院2013年1月至2015年12月使用他克莫司的重症肌无力住院患者为研究对象,运用化学发光微粒子免疫分析法监测他克莫司血药浓度,荧光染色原位杂交方法检测CYP3A5*3基因多态性,并收集患者病历资料进行统计分析。结果 纳入171例重症肌无力患者,共进行254例次他克莫司谷浓度测定,结果在0~64.71 ng·mL-1之间,平均质量浓度为(5.22±5.80) ng·mL-1。分析浓度监测结果与患者情况显示,血药浓度与用药剂量存在一定相关性,同时还受到合并用药、CYP3A5*3基因多态性等因素有关。结论 他克莫司血药浓度受诸多因素影响,临床使用该药物时应全面综合考虑多重因素,实现个体化治疗。
Abstract
OBJECTIVE The analyze the results of tacrolimus blood concentrations in patients with myasthenia gravis and the influencing factors, provide references for rational clinical application. METHODS The data of tacrolimus blood concentrations and medical records in patients with myasthenia gravis in hospital were collected and analyzed from January 2013 to December 2015.Tacrolimus whole-blood concentrations were measured by chemiluminescent microparticle immunoassay and CYP3A5*3 gene polymorphism were detected by digital fluorescence molecule hybridization fluorescence. RESULTS The range of tacrolimus trough concentrations were from 0 to 64.71 ng·mL-1 and the average of concentration was(5.22±5.80) ng·mL-1 in 254 cases with 171 myasthenia gravis patients. The results showed that there was a certain correlation between concentration and dosage, and concentration was also related other factors such as the combination of drugs and CYP3A5*3 gene polymorphism. CONCLUSION The concentration of tacrolimus are affected by many factors, so when tacrolimus is used, multiple factors should be considered comprehensively to achieve individualized treatment.
关键词
重症肌无力 /
他克莫司 /
治疗药物监测
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Key words
myasthenia gravis /
tacrolimus /
therapeutic drug monitoring
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中图分类号：
R969
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参考文献
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脚注
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基金
国家卫生计生委保健局保健重点科研项目资助(W2016ZD01)
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