摘要
目的：研究肝移植术后他克莫司在少年、儿童和成人患者中的给药剂量、血药浓度及影响因素的差异。方法：按照年龄将23名肝移植患者分为儿童组（1～12岁），少年组（12-18岁），成人组（〉18岁）。采用微粒子酶免疫分析法（MEIA）检测患者术后他克莫司的全血谷浓度。对体质量校正后剂量、血药浓度、剂量校正下的血药浓度的均值进行组间比较。血药浓度的影响因素用多元逐步回归的方法进行分析。结果：肝移植术后儿童组平均给药剂量为（0．22±0．23）mg^-1·kg^-1·d^-1，少年组（0．13±0．06）mg·kg^-1·d^-1，成人组（0．07±0．02）mg·kg^-1·d^-1，经方差分析，组间差异均有显著性（P〈0．05）。患者的全血谷浓度差异无显著性（P〉0．05）。剂量校正下浓度在儿童组和少年组，少年组和成年组间差异有显著性，在儿童组和成人组间差异无显著性。回归分析表明影响他克莫司浓度的因素有：AGE，HCT，ALB，TBIL，BUN，Cr。结论：他克莫司的给药剂量在个体间的波动很大。达到近似血药浓度时，成年组给药剂量最低，儿童组最高，且儿童、少年组血药浓度影响因素与成人有明显的不同。因此医生应该考虑儿童患者的特点和对血药浓度的诸多影响因素进行个体化用药。
OBJECTIVE To investigate the difference of the dosage and whole blood concentration between pediatric and adult patient who use Tacrolimus after liver transplantation and the influence factors. METHODS According to age, the patients were separated into three groups,the pediatric group（agel-12）, adolescent group（age12-18）,adult group（age〉18）, The FK506 trough level was assayed by MEIA, Compared the mean value of dosages revised by body weight, concentrations, and concentrations revised by dosage in three groups, The factors might influence FK506 concentration were analyzed by Stepwise algorithm of multivariate regression analysis. RESULTS The mean dose of FK506 after liver transplantation were （0. 22 ±0. 23） mg·kg^-1·d^-1 , （0. 13 ±0. 06） mg·kg^-1·d^-1 and （0. 137± 0. 02）mg·kg^-1·d^-1 respectively in pediatric group, adolescent group and adult group（P〈0. 05）. There was no significantly difference of mean concentrations in there groups. Factors influencing concentration were AGE, HCT, ALB, TBIL, BUN, Cr, CONCLUSION There is a wide individual variation on FK506 whole-blood concentration. To reach the same level, the pediatric and adolescent group must be given with more FK506. The influencing factors on concentration of FK506 may assist physicians in individualizing decisions especially for pediatric liver transplant recipients.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2008年第19期1650-1653,共4页
Chinese Journal of Hospital Pharmacy
