肾病综合征患者他克莫司血药浓度影响因素研究

Influence factors on blood concentration of tacrolimus in patients with nephritic syndrome

目的:对肾病患综合征患者他克莫司(FK506)血药浓度监测结果进行分析,并探讨其影响因素。方法:采用回顾性调查方法,查阅我院肾内科口服FK506治疗的住院患者病历,记录血药浓度、患者一般资料、用药情况及实验室检测指标,应用SPSS 17.0统计软件对数据进行多元线性回归分析。结果:66例使用FK506治疗的患者,血药浓度在有效范围内的占40.91%,低于有效浓度范围的占54.55%,高于有效浓度范围的占4.55%。多元线性回归结果显示肾病综合征患者FK506剂量校正血药浓度与患者总胆固醇、可升高FK506血药浓度的合并用药及肌酸激酶之间存在具有统计学意义的相关性(P<0.01)。结论:肾病综合征患者FK506血药浓度个体差异大,总胆固醇、可升高FK506血药浓度的药物及肌酸激酶是其血药浓度主要影响因素。

Objective:To investigate the influence factors of blood concentration of tacrolimus,and to provide reference for clinical use of tacrolimus(FK506).Methods:66 patients with nephrotic syndrome,who received hospitalized treatment in nephrology department of our hospital were enrolled in this study.The blood concentration of FK506,general data and laboratory testing values and so on,were recorded and analyzed using multiple linear regression method by SPSS 17.0 software.Results:Among the 66 patients,40.91%patients’FK506 concentration fell in the effective range,54.55%below the effective range,and 4.55%above the effective range.Correlations were found in unit dose of blood concentration for tacrolimus with total cholesterol(CHO)combination with drugs that increase the FK506 blood concentration,and serum creatinine(P<0.01).Conclusion:The FK506 blood concentration in patients with nephrotic syndrome patients is greatly varied between individuals,and CHO,drugs that increase FK506 concentration and CK are main factors affecting FK506 blood concentration in nephrotic syndrome patients.