他克莫司作为成人肝移植术后的一线免疫抑制剂,因疗效确切而被广泛使用。然而,其治疗窗窄,药动学个体差异大,临床中难以短期内制订个体化给药方案。利用群体药动学(PPK)的方法对药动学参数进行估计,可以为患者术后早期制订初步的个体化给药方案。本实验通过文献检索,考察国内外成人肝移植患者中他克莫司PPK建模的相关文献,重点总结成人肝移植口服他克莫司的PPK模型受人口学特征、血生化指标、合并用药、肝肾功能、遗传因素、术后时间、剂量等多重因素的影响,为运用PPK制订成人肝移植口服他克莫司受者个体化给药方案提供文献支持。
Abstract
Tacrolimus is widely used as a first-line immunosuppressant after adult liver transplantation. However, because of narrow treatment window and pharmacokinetic individual differences, it is difficult to formulate individualized dosing regimens in short term. Pharmacokinetic parameters that estimated by population pharmacokinetics(PPK) can provide a preliminary individualized regimen for early postoperative patients. This paper collected literatures on PPK modeling of orally administered tacrolimus in adult liver transplantation patients through literature search. And multiple influencing factors of PPK model was mainly summarized, such as demographic characteristics, blood biochemical index, combined medication, liver and kidney function, genetic factors, postoperative time and dosage. It will provide literature support for the development of individualized dosing regimens for oral tacrolimus recipients using the PPK protocol for adult liver transplantation.
关键词
群体药动学 /
成人肝移植 /
他克莫司
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Key words
population pharmacokinetics /
adult liver transplantation /
tacrolimus
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中图分类号:
R969.1
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脚注
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基金
医学科学研究基金项目资助(YWJKJJHKYJJ-B16244);国家自然科学基金青年项目资助(81703690);中国人民武装警察部队后勤学院博士启动基金资助(WHB201711);天津市第一中心医院科技基金(院:CM201806)
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