摘要
目的:分析1~12岁肾病综合征(NS)患儿他克莫司血药浓度监测结果及其影响因素。方法:纳入2018年9月-2021年12月我院儿肾科225例口服他克莫司治疗的NS患儿,记录一般资料、实验室指标和血药浓度监测结果,采用单因素和多因素线性回归分析性别、年龄、红细胞计数、红细胞压积、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酸激酶、总胆固醇等对他克莫司血药浓度的影响。结果:在给予相同初始剂量前提下,年龄在高水平组与中、低水平组之间的差异有统计学意义(P<0.05),高浓度组存在较多大龄患儿。年龄、红细胞计数、肌酸激酶、总胆固醇水平与他克莫司血药浓度均存在相关性(P<0.05);除肌酸激酶与血药浓度呈负相关外,其余指标与血药浓度间均呈正相关。结论:年龄、红细胞计数、总胆固醇、肌酸激酶影响NS患儿他克莫司血药浓度,临床需综合评估,给予合适的初始给药剂量,并监测血药浓度,及时调整剂量。
Objective:To analyze the blood concentration monitoring results of tacrolimus(FK506)in children with nephrotic syndrome aged 1-12 years and discuss the influencing factors.Methods:Retro-spective analysis was performed to review the hospitalized children who were treated with FK506 orally in the Pediatric Nephrology Department of our hospital from September 2018 to December 2021.The informa-tion,laboratory indicators and blood drug concentration monitoring results were recorded.Univariate and multivariate linear regression analyses were performed to evaluate the effects of gender,age,red blood cell count,hematocrit,alanine aminotransferase,aspartate aminotransferase,creatine kinase,total choles-terol and other factors on tacrolimus blood concentrations.Results:Under the premise of administering the same initial dose,the difference in age between the high-level group and the middle-and low-level groups was statistically significant(P<0.05),with a higher proportion of older children in the high-concentration group.Age,red blood cell count,creatine kinase and total cholesterol level were all corre-lated with tacrolimus blood concentration(P<0.05).Except for creatine kinase,which showed a negative correlation with tacrolimus blood concentration,the other indicators were positively correlated with tacroli-mus blood concentration.Conclusion:Age,red blood cell count,total cholesterol and creatine kinase sig-nificantly affect the plasma concentration of tacrolimus in children with nephrotic syndrome.Comprehen-sive clinical evaluation is needed to give appropriate initial dose and adjust the dose in time under the monitoring of tacrolimus plasma concentration.
作者
徐启坤
化霜
方芸
王峰
程敏
陶晶晶
周志愚
XU Qikun;HUA Shuang;FANG Yun;WANG Feng;CHENG Min;TAO Jingjing;ZHOU Zhiyu(Department of Pharmacy,Nanjing BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing 210019,China)
出处
《药学与临床研究》
2025年第1期71-74,共4页
Pharmaceutical and Clinical Research
基金
南京医科大学科技发展基金一般项目(NMUB20220147)。
关键词
他克莫司
血药浓度
影响因素
儿童肾病综合征
Tacrolimus
Blood drug concentration
Influencing factors
Nephrotic syndrome in children
