摘要
目的探讨肝移植受者术后早期他克莫司(tacrolimus,Tac)血药浓度的特点及影响因素,为肝移植受者的个体化治疗提供依据。方法选取本中心肝移植受者87例,对肝移植受者术后14 d内Tac的血药浓度进行分析,并以C0/D/W为因变量,受者基本资料、肝肾功能、CYP3A5基因型和合并使用钙通道阻滞药等为自变量,用多元逐步回归方法探讨Tac血药浓度的影响因素。结果术后早期Tac的波动范围较大,47.1%的受者Tac血药浓度不能在术后14 d内达到目标范围,受者体重、红细胞比容、CYP3A5基因型、白蛋白、合并使用钙通道阻滞药、丙氨酸转氨酶(alanine aminotransferase,ALT)对术后早期Tac的血药浓度有影响。结论肝移植术后早期Tac血药浓度受多种因素的影响,临床药师应与医生密切合作,综合考虑各种影响因素,制定更加合理的个体化治疗方案。
Objective To explicit the characteristics and influencing factors of tacrolimus blood concentration in early postoperative stage of liver transplantation recipients,and to provide a basis for individualized treatment.Methods Whole blood trough concentrations of tacrolimus were analyzed in 14 days post liver transplantation in 87 recipients.Using C0/D/W as the dependent variable,the recipient demographic factors,liver and kidney function,CYP3A5 genotype and combined therapy with calcium channel blockers were considered as independent variables,the influencing factors of tacrolimus blood concentration were analyzed by multivariate stepwise regression method.Results Variability of tacrolimus blood concentration was significant and 47.1%of the recipients could not reach the target range in the first 14 days post transplantation.Recipient body weight,hematocrit,CYP3A5 genotype,albumin,combined use of calcium channel blockers,alanine aminotransferase were factors influencing the blood concentration of tacrolimus in the early postoperative period.Conclusion The blood concentration of tacrolimus in the early stage post liver transplantation is affected by many factors.The clinical pharmacist should work closely with the clinical doctor to comprehensively consider various influencing factors and formulate a more reasonable individualized treatment plan.
作者
秦寅鹏
陈凡
闫美玲
张弋
Qin Yinpeng;Chen Fan;Yan Meiling;Zhang Yi(Department of Pharmacy,Tianjin First Central Hospital,Tianjin 300192,China)
出处
《实用器官移植电子杂志》
2020年第1期18-21,共4页
Practical Journal of Organ Transplantation(Electronic Version)
基金
北京医卫健康公益基金会医学科学研究基金资助项目(YWJKJJHKYJJ-B16244)。
关键词
肝移植
他克莫司
血药浓度
Liver transplant
Tacrolimus
Blood concentration
