论文部分内容阅读
目的探讨五酯胶囊对CYP3A5基因分型肾病综合征患儿他克莫司血药浓度的影响。方法肾病综合征患儿30例,口服他克莫司0.1mg·kg~(-1)·d~(-1)诱导治疗,但血药浓度始终偏低。依CYP3A5基因分型,*1/*1型6例(A组),*1/*3型13例(B组),*3/*3型11例(C组)。加用五酯胶囊口服,每日2次。用药前和用药1周后检测患儿他克莫司血药物浓度及肝肾功能,并测定尿N-乙酰氨基葡萄糖苷酶(NAG)水平。结果服用五酯胶囊后,A、B、C组他克莫司血药浓度均较服药前升高[(6.07±0.79)ng/ml vs.(2.75±0.92)ng/ml、(8.45±1.14)ng/ml vs.(3.37±0.92)ng/ml、(10.97±2.80)ng/ml vs.(4.00±1.03)ng/ml](P<0.05或P<0.01),且C组升高较A、B组更加明显(P<0.05)。三组口服五酯胶囊前后肝肾功能相关指标及尿NAG水平比较均无统计学差异(P>0.05)。结论口服五酯胶囊对肾病综合征患儿他克莫司血药浓度有明显的提升效果,尤以CYP3A5*3/*3型患儿效果更为明显。
Objective To investigate the effect of Wuzhi capsule on plasma concentration of tacrolimus in children with CYP3A5 genotyping nephrotic syndrome. Methods Thirty children with nephrotic syndrome were treated with 0.1 mg · kg ~ (-1) · d ~ (-1) tacrolimus orally, but the plasma concentration was always low. According to CYP3A5 genotyping, 6 cases (group A) of * 1 / * 1 type, 13 cases of * 1 / * 3 type group (B group) and 11 cases of * 3 / * 3 type group (C group). Plus five ester capsules oral, 2 times a day. The concentrations of tacrolimus and hepatic and renal function in children were measured before treatment and one week after treatment. The urine N-acetylglucosaminidase (NAG) level was measured. Results After administration of Wuzhi capsule, the plasma concentrations of tacrolimus in groups A, B and C were significantly higher than those before treatment [(6.07 ± 0.79) ng / ml vs. (2.75 ± 0.92) ng / ml and (8.45 ± 1.14 (P <0.05 or P <0.01), and the level of C in group C was significantly higher than that in group C (3.37 ± 0.92) ng / ml and (10.97 ± 2.80) ng / A, B group more obvious (P <0.05). The indexes of liver and kidney function and urinary NAG levels in three groups before and after oral administration of five esters showed no statistical difference (P> 0.05). Conclusion Oral Wusu Capsule has a significant effect on the concentration of tacrolimus in children with nephrotic syndrome, especially in children with CYP3A5 * 3 / * 3 type.