环孢素在肾病综合征患者中的用药状况分析

Clinical analysis of cyclosporine use in nephrotic syndrome patients

目的分析环孢素在我院肾病综合征患者中的用药情况及特点。方法收集2014年北京大学第一医院全年使用环孢素治疗肾病综合征的住院患者病例,提取患者的基本情况、治疗药物监测情况、合并用药情况、疗效及药物不良反应信息,用SPSS 22.0软件进行统计分析。结果共纳入68例患者,住院次数为76次,进行环孢素谷浓度测定132例次。患者肾病综合征治疗的有效率为36.84%,环孢素药物不良反应发生率为4.41%。环孢素谷浓度在50~100ng·m L^(-1)时,有效率最高。47.06%的患者住院期间合并使用地尔硫治疗。合用地尔硫的患者与不合用患者的平均谷浓度、达到50~100 ng·m L^(-1)谷浓度范围所需时间、环孢素平均剂量及有效率比较,差异均无统计学意义(均P>0.05)。结论本院肾病综合征患者环孢素的使用基本合理,但在治疗药物监测方面还存在一些不足。

Objective To analyze the current situation and characteristics of cyclosporine in patients with nephrotic syndrome in our hospital,and to promote the rational use of drugs. Methods The patients with nephrotic syndrome treated with cyclosporine in 2014 were enrolled in this study. The data were collected retrospectively in respect of the basic data of patients, the treatment of drug monitoring, the combined medication,the curative effect and adverse drug reaction. The above data were analyzed by SPSS 22. 0 software. Results A total of 68 patients were enrolled in the hospital. The number of hospitalizations was 76 and the number of the determination of cyclosporine trough concentration was132. The effective rate of treatment of nephrotic syndrome was 36. 84%,the incidence of cyclosporine adverse reactions was 4. 41%. Cyclosporine trough concentration in 50-100 ng·m L-1 get the highest efficiency.7. 06% of patients were treated with the combined diltiazem during hospitalization. There was no significant difference in the mean trough concentration,the time required to reach the trough concentration range in 50-100 ng · m L-1,and the mean dose and effective dose of cyclosporine between the patients treated with the combined diltiazem and those who did not use diltiazem（ all P〈0. 05）. Conclusion The use of cyclosporine in patients with nephrotic syndrome is basically reasonable,but there are still some deficiencies in the monitoring of therapeutic drugs.