摘要
目的:分析再生障碍性贫血患者环孢素A血药浓度与药物性肝、肾损伤之间的相关性,探讨环孢素A血药浓度在监测肝肾毒性的意义,为临床个体化用药提供理论依据。方法:选择使用环孢素A作为主要治疗药物的再生障碍性贫血患者147例,服药3d后采用HPLC-UV法常规测定患者晨起服药前10min及服药2h后的血药浓度,并同时测定肝肾功能指标,统计分析环孢素A血药浓度的谷浓度(C_0)和峰浓度(C_2),及其与患者肝、肾功能的相关性。结果:149例患者共监测环孢素A血药浓度1 236例次,34例患者(22.82%)出现药物性肝损伤,51例患者(34.23%)出现药物性肾毒性。肝损伤患者C_0平均为(297.92±74.14)μg·L^(-1),C_2平均为(944.47±148.47)μg·L^(-1);肾损伤患者C_0平均为(311.41±52.80)μg·L^(-1),C_2平均为(926.25±136.02)μg·L^(-1);患者肝、肾功能指标较正常组均显著性升高(P<0.05)。环孢素A血药浓度与肝功能指标(ALT、AST、TBIL)及肾功能指标(SCr、BUN、UA)呈显著相关性。结论:环孢素A的肝肾毒性与其血药浓度存在一定相关性,且C_2值可能是更有价值的药物性肝损伤预测指标。
Objective： To analyze the correlation between cyclosporin A blood concentration and drug-induced liver and kidney in- jury in the patients with aplastic anemia, investigate the significance of cyclosporin A concentration in the monitoring of liver and kidney toxicity, and provide theoretical basis for clinical individualized drug use. Methods： A total of 149 patients with aplastic anemia trea- ted with cyclosporin A as the main therapeutic drug were selected, and after 3-day treatment, the blood concentration of cyclosporin A was detected by an HPLC-UV method 10 minutes before the administration and 2 hours after the administration. The liver and kidney function were measured at the same time. The correlation between the different concentration of cyclosporine A and the change of liver and kidney function was analyzed. Results： All the patients were monitored cyclosporine A blood concentration with 1 236 samples, and 34 patients （22.82%） were with drug-induced liver injury and 51 patients （34.23%） showed drug-induced kidney toxicity. The average Co of liver injury patients was （297.92 ± 74.14） μg·L-1, and C2 was （944.47 ± 148.47 ）μg·L-1, while the average Co of kidney injury patients was （311.41 ± 52.80） μg·L-1, and C2 was （926.25± 136.02） μg·L-1. The function indices of liver （ ALT, AST, TBIL） and kidney （ SC, BUN, UA） were significantly higher than those in the normal group （P 〈 0.05）, and the blood concentration of cyclosporin A was significantly correlated with the liver, and kidney function. Conclusion： There is a certain correla- tion between cyclosporine A - induced toxicity and its blood concentration and C2 may be a more valuable predictor for drug - induced liver injury.
作者
王欣晨
商玉萍
Wang Xinchen Shang Yuping(Department of Pharmacy, Anhui Cancer Hospital, Flefei 230031, China)
出处
《中国药师》
CAS
2017年第3期513-515,共3页
China Pharmacist
关键词
再生障碍性贫血
环孢素A
药物性肝损伤
药物性肾损伤
血药浓度
Aplastic anemia1
Cyclosporin A
Drug- induced liver injury
Drug- induced kidney injury
Blood drug concentration
