我院异基因造血干细胞移植患者环孢素血药浓度监测情况分析

Analysis of cyclosporine blood concentration in allogeneic hematopoietic stem cell transplantation patients in our hospital

目的:分析我院异基因造血干细胞移植(allo-HSCT)患者环孢素血药浓度监测情况。方法:以我院进行allo-HSCT并采用环孢素联合短程甲氨蝶呤为基础方案预防移植物抗宿主病(GVHD)的患者为研究对象,分为>14岁和≤14岁两组,分别统计两组患者环孢素血药浓度监测次数、静脉和口服两种给药途径下的环孢素剂量和血药浓度结果,探讨环孢素血药浓度分布和达标情况。结果:≤14岁组环孢素的给药剂量明显大于>14岁组且前组达到目标血药浓度所需时间更短,两组患者环孢素血药浓度分布情况和达标率(36.24%vs 37.52%)无显著性差异(P=0.598)。共有17.39%的患者因各种原因将环孢素更换为他克莫司。结论:环孢素血药浓度的分布和达标率在上述两组中无显著性差异。儿童患者可耐受较高的环孢素剂量,有助于尽早达到目标血药浓度。

Objective:To analyze the blood concentration of cyclosporine A(CsA)in allogeneic hematopoietic stem cell transplantation(allo-HSCT)patiens in our hospital.Methods:Patients who used CsA and methotrexate(MTX)to prevent graft versus host disease(GVHD)after allo-HSCT were divided into>14 years old group and≤14 years old group according to the age.The monitoring times of blood concentration,the dose and blood concentration of CsA under intravenous and oral administration were counted respectively in the two groups to investigate the distribution and compliance rate of CsA in plasma.Results:Dose of CsA in≤14 years old group was obviously higher than that in>14 years old group.And the time required for the former group to reach the target plasma concentration was shorter.There were no significant differences in distribution of CsA blood concentration and the rate of reaching the standard blood concentration of CsA between the two groups(36.24%vs 37.52%,P=0.598).A total of 17.39%of the patients used tacrolimus to replace CsA for various reasons.Conclusion:There were no significant differences in distribution of CsA blood concentration and the rate of reaching the standard blood concentration of CsA between the two groups.Pediatric patients were well-tolerated to higher dose of CsA,which was helpful to achieve the target plasma concentration as soon as possible.