治疗药物监测在环孢素A个体化给药中的应用及研究进展

Therapeutic drug monitoring in the individualized administration of cyclosporin A:Application and research progress

环孢素A(cyclosporine A,CsA)是一种细胞免疫抑制剂,广泛应用于器官移植、血液疾病和自身免疫性疾病。因其口服生物利用度差,个体差异大且易发生不良反应,所以临床上对CsA进行治疗药物监测(therapeutic drug monitoring,TDM)及个体化给药可以确保其用药安全性及有效性。但CsA治疗窗窄,其血药浓度受年龄、性别、饮食、药物因素、遗传因素等多方面的影响。因此本文结合国内外文献报道对CsA的TDM及个体化给药的应用研究进行综述,为临床安全、合理用药提供更有价值的参考。

Cyclosporine A(CsA)is a kind of cellular immunosuppressant,which is widely used in organ transplantation,blood diseases and autoimmune diseases.Because of its poor oral bioavailability,individual differences and prone to adverse reactions,so clinical therapeutic drug monitoring(TDM)and individual administration of CsA can ensure its safety and effectiveness.However,the treatment window of CsA is narrow,and its blood concentration is affected by age,sex,diet,drug factors,genetic factors and so on.Therefore,combined with the literature reports at home and abroad,this paper reviews the research on the application of TDM and individual drug administration of CsA,in order to provide more valuable reference for clinical safe and rational drug use.