成人异基因造血干细胞移植术后影响环孢素A血药浓度的相关因素考察

Evaluation of Factors Related to Blood Concentration of Cyclosporine A in Adult Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

目的:考察成人异基因造血干细胞移植术后2周内环孢素A(CsA)血药浓度的相关因素。方法:回顾性调查北京大学第一医院异基因造血干细胞移植术后2周内使用CsA的患者病历,记录人口统计学资料、CsA全血浓度、相应的生化检验值以及用药记录等,应用PASWStatistics18.0统计软件对CsA谷浓度(c0)、CsA单位剂量血药浓度(c1)与生化检验数据、年龄、体质量、性别和合并用药等相关因素进行分析。结果:在异基因造血干细胞移植术后2周内,c0与总胆红素(TBIL)、直接胆红素(DBIL)、总胆汁酸(TBA)存在相关性(P<0.01),c1与年龄、TBIL、DBIL、TBA存在相关性(P<0.01)。c0、c1与体质量没有相关性,性别和合并用药(去氧孕烯炔雌醇片和环磷酰胺)对CsA浓度没有影响。结论:在异基因造血干细胞移植术后2周内,CsA浓度与TBIL、DBIL、TBA、年龄具有显著相关性。

OBJECTIVE： To study the possible factors related to the blood concentration of cyclosporine A （CsA） in adult pa- tients underwent allogeneic hematopoietic stem cell transplantation （allo-HSCT） within 2 weeks. METHODS： A retrospective analy- sis was performed in patients underwent allo-HSCT within 2 weeks in peking university first hospital. The demographics of pa- tients, whole blood concentrations of CsA, biochemical tests and drug therapies were recorded. The trough concentration of CsA （Co）, blood concentration of unit dose of CsA （Cl）, data of biochemical test, age, body weight, gender, drug combination and oth- er factors were analyzed using PASW Statistics 18.0 software. RESULTS： Significant relationship were noted between Co and TBIL, DBIL and TBA （P〈0.01） ; significant relationship was noted between c1 and ages, TBIL, DBIL and TBA （P〈0.01）. No relation- ships were found between co, ca and body weight. Gender and drug combination （Desogestrel and ethinylestradio tablets and cyclo- phosphamide） did not show significant effects on blood concentration of CsA. CONCLUSIONS： TBIL, DBIL, TBA and age have significantly relationship with blood concentration of CsA within 2 weeks after allo-HSCT.