10606例次环孢素治疗药物监测结果分析

Analysis of 10606 cases of cyclosporine therapeutic drug monitoring data

目的对我院2010年8月-2012年12月的10606例次环孢素治疗药物监测（TDM）数据进行统计分析．指导临床合理用药和减少药物不良反应。方法对我院1888例患者10606次符合入选条件的环孢素监测结果进行统计分析。，结果首次治疗药物监测结果在治疗窗内的仅占40．3％；治疗药物监测次数为1、2、3以及超过10次者分别占总人数的29．2％、13．7％、8．9％、14．8％；在监测次数为3次～5次的患者中，第1、2、3、4、5次治疗药物监测结果在治疗窗内的分别占总人数的38．2％、43．8％、45．9％、40．4％、33．9％。结论环孢素的药动学参数个体差异大．及时监测患者的环孢素血药浓度，可以指导临床合理用药。但目前监测次数偏少，达标情况不理想，即使监测多次也不能达到很好的效果，这可能与环孢索血药浓度受多种因素影响有关。

OBJECTIVE To evaluate 10606 cases of therapeutic drug monitoring （TDM） of cyclosporine in our hospital during August 2010 to December 2012 and to guide clinical rational drug use and reduce adverse drug reac- tions. METHODS Analysis and statistics of cyclosporine TDM data of 10606 cases （ 1888 subjects） in our hospital were carried out. RESULTS Among all the I st TDM concentration, only 40.3% patients was within the therapeutic window. Constituent ratio of patients whose drug concentrations were monitored once, twice, three times or more than ten times respectively was 29.2%, 13.7% ,8.9% and 14. 8%. Among all the subjects undergoing 3 -5 times of TDM,constituent ratio of patients whose drug concentrations of the 1 st,2nd,3rd,4th or 5th TDM were within thera- peutic window was 38.2% ,43.8% ,45.9% ,40.4% and 33.9% respectively. CONCLUSION The pharmacoki- netic parameters of cyclosporine have varied with individual,timely TDM of patients＇ blood drug concentrations can guide clinical rational drug use. But the TDM times are much less than enough at present,the status of which is not satisfactot-y. Even multiple TDM can not guarantee the results. It may correlate with many factors that can effect the concentration of cyclosporine.