论文部分内容阅读
目的探讨有限采样法监测肾移植受者血霉酚酸(MPA)浓度的可行性及其方案。方法21例肾移植患者分别在术后第3、11、21d服用霉酚酸酯(MMF)前以及服药后0.5、1、1.5、2、2.5、4、8、12h等9个时点采取外周静脉血,采用高压液相色谱法检测血浆MPA浓度,用线性梯形法计算服药后0~12h药时曲线下面积(AUC0-12),用逐步回归法建立多元回归模型。结果术后第3、11、21d所测得的MPA药时曲线形态基本相同,部分呈现双峰现象。服药后8、4h及服药前浓度(C8、C4及C0)与MPA-AUC0-12的相关性相对较好;采用逐步回归模型分析,根据C1、C2.5、C4、C8计算所得的AUC与标准AUC的相关性最好,C1、C2.5、C8次之,综合考虑检测成本和可操作性,推荐C1、C2.5、C8三个时点的多元回归模型AUC=4.809+6.434×C8+2.454×C2.5+0.980×C1。结论汉族肾移植患者口服多剂MMF后,以服药后1、2.5、8h的血MPA浓度(C1、C2.5、C8)估算MPA-AUC0-12为好,可作为临床监测MPA浓度的指标。
Objective To investigate the feasibility and the scheme of finite sampling in monitoring the concentration of blood plasma of mycophenolate mofetil (MPA) in renal transplant recipients. Methods Twenty-one kidney transplant recipients were treated with MMF at 3, 11 and 21 days after operation and 0.5, 1, 1.5, 2, 2.5, 4, 8, The plasma MPA concentration was measured by high pressure liquid chromatography. The area under the curve of drug concentration (AUC0-12) at 0-12h after administration was calculated by linear trapezoidal method. Multiple regression model was established by stepwise regression. Results The morphological changes of MPA on the 3rd, 11th and 21st day after operation were basically the same, and some showed bimodal phenomenon. The correlation between MPA-AUC0-12 and 8,4 h and 8-h pretreatment (C8, C4 and C0) was relatively good. Using stepwise regression analysis, the calculated AUC The standard AUC correlation is the best, C1, C2.5, C8 times, considering the detection cost and maneuverability, recommended multiple regression models of C1, C2.5, C8 time points AUC = 4.809 + 6.434 × C8 + 2.454 × C2.5 + 0.980 × C1. CONCLUSIONS: MPA-AUC0-12 is estimated as MPA-AUC0-12 at 1,25 and 8 h after taking MMF in Han patients. It can be used as an index to monitor the concentration of MPA.