骨髓移植患者环孢素血药浓度的HPLC和PAFPIA法的比较

Comparison of HPLC and PAFPIA on Determination of Blood Concentration of CsA in Patients recieving BMT

建立了一种专一性测定骨髓移植(BMT)患者全血环孢素(Cs)主药浓度的高效液相色谱(HPLC)法,并与非专一性测定Cs主药及代谢物二者总浓度的多抗荧光偏振免疫(PAFPIA)法比较。两者测定值,经t检验具统计学极显著性差异(P<0.01);经相关与回归分析,呈线性关系,方程为:Y_(PAFPIA)=2.59X_(HPLC)+37.35,r=0.9247,n=53(P<0.01)。建议:监测BMT患者Cs时,既要采用PAFPIA法,又要采用HPLC法。PAFPIA/HPLC比值的实际意义:通过该比值的变化,可了解肝功能异常或Cs与药酶诱导剂或抑制剂合用时对BMT患者Cs代谢及排泄的影响程度,籍以调整治疗方案,以防治移植物抗宿主病(GVHD)。

A specific high performance liquid chromatography (HPLC) for determination of blood concentration of CsA in the patients recieving bone marrow transplantation (BMT) was established and compared with non-specific polyclonal antibody flurescence polarization immunoassay (PAFPIA) for determination of both the parent CsA and its metabolites . There was very significant difference between both the measure values (P<0.01). Both values obtained by two determining methods was analysed by correlation and regression. HPLC and PAFPIA displayed a linear relationship. The curve equation was YPAFPLA = 2.59, XHPLC+37.35, r=0.924 7, n=53(P<0.01). It was suggested that both PAFPIA and HPLC were used for monitoring the patients recieving BMT. The real significance of specific value from PAFPIA/HPLC was : the extend effected of hepatic dysfunction or combination CsA with enzyme induced agent or inhibitor on CsA metabolism and excretion in the patients recieving BMT could be understood from the change of this specific value, according to changed extend to adjust the therapeutical project, and to prevent and treat graft-versus-host disease (GVHD).