肾移植患者吗替麦考酚酯药时曲线下面积与不良反应的相关性

目的:探讨肾移植患者吗替麦考酚酯(MMF)血药浓度与药品不良反应(ADR)发生的相关性。方法:通过均相酶免疫法(EMIT)测定血浆麦考酚酸药时曲线下面积(MPA-AUC),对某院2012年2月-2014年2月599例肾移植患者发生药品不良反应进行回顾性分析。结果:肾移植患者住院情况在不同性别、年龄、移植时间存在显著性差异(P<0.05),移植时间超过1个月患者各类ADR发生与MPA-AUC呈线性相关(P=0.0162),且带状疱疹的发生率在MPA-AUC值<30 mg·L^-1·h^-1、30~60 mg·L^-1·h^-1、>60 mg·L^-1·h^-1中,有显著性差异(P=0.014)。结论:肾移植术后各类ADR的发生与MPA-AUC相关,对其监测具有一定意义。采取浓度控制MMF给药剂量更加有利于药物的合理使用。

Correlations between adverse drug reactions and area under concentration-time curve of mycophenolate mofetil patients received kidney transplantation

OBJECTIVE To investigate correlation between adverse drug reactions and area under concentration-time curve (AUC) of mycophenolate mofetil patients received kidney transplantation.METHODS AUC of mycophenolic acid (MPA-AUC) was determined by enzyme-multiplied immunoassay test (EMIT). Adverse drug reactions were collected in 599 patients received kidney transplantation from February, 2012 to February, 2014, and analyzed.RESULTS Hospital status was significantly different in gender, age and transplantation time (P<0.05). For patients received transplantation for more than 1 month, different ADRs and MPA-AUC presented linear correlation (P=0.0162). Incidence of herpes zoster was significantly different at MPA-AUC values of <30 mg·L^-1·h^-1, 30-60 mg·L^-1·h^-1, >60 mg·L^-1·h^-1 (P=0.014).CONCLUSION After kidney transplantation, ADRs were associated with MPA-AUC, and MPA-AUC monitoring has certain significance. MMF dose controlled by concentration is more favorable for rational drug use.