我院2012年7种治疗药物监测结果回顾性分析

Retrospective analysis of 7 kinds of therapeutic drug monitoring results in our hospital in 2012

目的：对医院2012年1~12月7种治疗药物监测（TDM）的结果进行回顾性分析，探讨治疗药物监测在临床上的应用价值。方法应用均相酶放大免疫分析法（EMIT）测定他克莫司、环孢素、苯妥英钠、卡马西平、丙戊酸、苯巴必妥、万古霉素7种药物的血药浓度，并对测定结果进行分析总结。结果他克莫司和环孢素在肾移植术后抗排斥治疗中需要密切监测药物疗效和调整药物剂量。抗癫痫药的 TDM 未引起足够的重视，其中苯妥英钠出现中毒反应最多。万古霉素的临床送检量最少，与临床使用量少和血药浓度是否需要监测存在争议性有关。结论开展血药浓度监测，能减少药源性疾病的发生，提高癫痫患者的生活质量，保证患者用药安全有效。

Objective From January to December 2012,7 kinds of results of therapeutic drug monitoring（TDM） were retrospectively analyzed in our hospital to explore the value of therapeutic drug monitoring in clinical practice. Methods By using homogeneous enzyme immunoassay amplification（EMIT）,the blood concentration of 7 kinds of drugs including ta-crolimus,cyclosporine,phenytoin,carbamazepine,valproic acid,benzene barbital,vancomycin were detected respectively. The measurement results were analyzed and summarized. Results The tacrolimus and cyclosporine in renal transplant recipients anti-rejection therapy demanded to be close monitoring and adjustment of the dose of drug efficacy. The TDM of antiepileptic drugs did not attract enough attention,including phenytoin appeared up to toxic reactions at most. The clinical inspection of vancomycin was minimum amount,this seemed to be connected with clinical use less and whether the blood concentration need to monitor was controversial. Conclusion The development of blood drug concentration monitoring can reduce the occurrence of drug induced diseases,improve the quality of life in patients with epilepsy and ensure the safety of patients effectively.