某院5种治疗性药物血药浓度检测结果的回顾性研究

Retrospective Study on the Results of Blood Drug Concentration Detection of Five Therapeutic Drugs in A Hospital

目的通过对我院2017年5月至2017年12月5种治疗药物检测(TDM)的结果进行回顾性研究分析,探讨TDM在临床上的应用价值。方法应用均相酶放大免疫分析法(EMIT)检测丙戊酸、万古霉素、环孢素、卡马西平、甲氨蝶呤5种药物的血药浓度,并采用系统回顾性分析对结果进行分析。结果5种治疗药物共进行1263例次检测。其中,测定数量最多的为丙戊酸占总数的47.98%,丙戊酸和卡马西平血药浓度达到有效浓度范围的比例高,环孢素、万古霉素血药浓度低于有效浓度;血药浓度监测对使用甲氨蝶呤的患者在解救治疗中起到重要作用。结论治疗药物监测对临床用药剂量调整具有重要的指导意义。应根据血药浓度检测调整给药方案,制定合理的个体化治疗方案,最大限度保证患者用药安全、有效、经济。

Objective To retrospectively analyze our hospital 5 kinds of therapeutic drug monitoring data from May 2017 to December 2017,discuss the role of therapeutic drug monitoring in clinical rational drug use.Methods Used Enzyme multiplied immunoassay technique(EMIT)to detect 5 kinds of therapeutic drugs including of valproic acid,cyclosporin,methotrexate,carbamazepine,vancomycin,and the results were retrospectively analyzed.Results 5 therapeutic drugs were detected 1263 times.Valproic acid had the most monitoring patients accounting for 47.98%in the hospital for all monitoring species number,therapeutic drugs of Carbamazepine and valproic acid concentration to achieve the effective therapeutic window range ratio is high,cyclosporine and vancomycin therapeutic drugs concentration is lower than the effective concentration;concentration monitoring plays an important role in the rescue and treatment of patients with methotrexate.Conclusion The monitoring of therapeutic drugs is of great signifi cance to the adjustment of clinical dosage.According to the monitoring of therapeutic drug concentration,the drug administration plan should be adjusted in time,and a reasonable individual treatment plan should be formulated to ensure the maximum safety,effectiveness and economy of patients medication.