139例重症肌无力患者他克莫司血药浓度监测结果分析

Blood Concentration Data of Tacrolimus in 139 Cases of Myasthenia Gravia

目的对他克莫司治疗重症肌无力患者的血药浓度监测结果进行分析,为临床制定个体化用药方案提供科学依据。方法收集火箭军总医院2010年1月至2016年3月139例重症肌无力住院患者口服他克莫司的血药浓度监测结果,分析疗效及患者性别、年龄、合并用药、用药剂量等因素与他克莫司血药浓度的关系。结果 139例重症肌无力患者他克莫司血药浓度监测结果共计730例次,其中292例次(40.0%)的血药浓度在4~8ng·ml^(-1),374例次(51.2%)血药浓度<4ng·ml^(-1),64例次(8.8%)血药浓度>8ng·ml^(-1)。结论他克莫司血药浓度个体差异大,其治疗重症肌无力疗效和不良反应与血药浓度密切相关,目前临床参考国外4~8ng·ml^(-1)治疗窗范围需要做必要的修正。

Objective To monitor the blood drug concentration of tacrolimus in patients with myasthenia gravia in order to facilitate individualized drug regimens.Methods The blood drug concentration of 139 cases of myasthenia gravia patients administrated with tacrolimus was collected,while the relationships between gender,age,drug combination,dosage and tacrolimus blood concentration were analyzed.Results Among the 139 cases of myasthenia gravia,the blood drug concentration was monitored 730 times in total.The serum concentration of 292 cases was within the effective serum concentration（4-8 ng·ml-1）,the concentration of 374 cases was less than 4 ng·ml-1,and the concentration of 64 cases was higher than 8 ng·ml-1.Conclusion The serum concentration of tacrolimus varies greatly in myasthenia gravia patients,and the therapeutic effect and adverse reactions are closely related to the blood concentration,thus making individualized dosing necessary.