不同血药浓度他克莫司对肾病综合征的疗效影响分析

Effects of different concentrations of tacrolimus on treatment of patients with nephrotic syndrome

目的分析不同血药浓度他克莫司对肾病综合征的疗效影响。方法选取本院2012年5月—2016年5月收治的90例肾病综合征患者为研究对象,患者服用他克莫司达到稳态血药浓度后,应用酶联免疫吸附测定法测定他克莫司全血谷浓度。随访3个月,观察药物疗效,比较患者给药剂量及血药浓度,分析患者不良反应发生率。结果治疗后完全缓解76例(84.4%),部分缓解9例(10.0%),无效5例(5.6%);完全缓解组、部分缓解组、无效组给药剂量分别为(0.05±0.01)mg/(kg·d)、(0.06±0.01)mg/(kg·d)、(0.07±0.02)mg/(kg·d),血药浓度为(8.44±3.25)ng/m L、(5.92±1.53)ng/m L、(3.34±0.86)ng/m L;完全缓解组、部分缓解组不良反应发生率显著高于无效组(P<0.05)。结论不同血药浓度他克莫司对肾病综合征的疗效有影响,临床上应将他克莫司全血谷浓度控制在5.19~11.69 ng/m L内,疗效满意。

Objective To analyze the effect of different concentrations of tacrolimus on ne- phrotic syndrome. Methods A total of 90 kidney disease cases in our hospital from May 2012 to May 2016 were as research objects, the tacrolimus blood concentration was determined by ELISA method when blood concentration reached steady state after taking tacrolimus. All patients were followed up for 3 months to observe the efficacy, dosage and concentration of the drugs, and the incidence of adverse reactions was analyzed. Results After treatment, there were 76 cases with complete remission （84.4%）, 9 cases （10%） with partial remission, 5 cases （5.6%） in invalid. The complete remis- sion group, partial remission group and ineffective group dosage were （0.05 ±0.01） mg/（kg · d）, （0.06± 0.01 ） mg/（ kg ·d）, and （0.07 ± 0.02） rag/（ kg ·d）, respectively. The concentration of drug in blood were （8.44±3.25） ng/mL, （5.92± 1.53） ng/mL, and （3.34±0.86） ng/mL. Ad- verse reaction rates were 45.6% and 44.4% in complete remission group and partial remission group, which were significantly higher than 20.0% in the invalid group, the differences were statistically sig- nificant （P 〈0.05）. Conclusion Different concentrations of tacrolimus have an effect on the treat- ment of nephrotic syndrome, the whole blood concentration of tacrolimus controlled in 5. 19 11.69 ng/mL can reach satisfactory effect.