五酯胶囊提高他克莫司血药浓度的耐受性研究

目的:通过分析他克莫司(tacrolimus,TAC)联合五酯胶囊(WZ capsules,WZ)治疗肾病综合征患者的他克莫司血药浓度及相关临床资料,探究五酯胶囊影响他克莫司血药浓度的变化规律,为临床合理用药提供依据.方法:收集中国医科大学附属盛京医院2018年10月至2019年12月服用他克莫司进行治疗的肾病综合征患...

Tolerance to the effects of WZ capsules on the blood concentration of tacrolimus

OBJECTIVE To analyze the blood drug concentrations of tacrolimus inpatients with nephrotic syndrome taking tacrolimus and WZ capsules and examine the effect of WZ capsules on the elevated concentration of tacrolimus so as to provide rationales for rational drug use in clinical practices.METHODS A total of 72 patients diagnosed with nephrotic syndrome and treated with tacrolimus from October 2018 to December 2019 were collected as subjects.General status,combination of medications and blood concentration of tacrolimus were recorded.The effect of WZ capsules on the blood concentration of tacrolimus was examined.Then according to the timing of combined use of WZ capsules,they were divided into three groups of pre-using,using for 1-3 months and using for 3-6 months.Finally the effects of combined WZ capsules on the blood concentration of tacrolimus over time were analyzed. RESULTS A total of 72 patients were included.The standardized blood drug concentrations of tacrolimus were(135.37±95.18) and(308.90±183.31) ng·kg·mL^-1·mg^-1 in TAC and TAC+WZ groups with significant difference(P<0.01).Twenty patients in TAC+WZ group with data from pre-drug combination to 6 months' drug combination were selected.All drug concentrations increased significantly in combination WZ capsule for 1-2 months.The average elevation was around(185.3±94.5)%.However,after 2 months of combined use,there were different degrees of decline in 18 patients.The average decline was around(21.7±15.8)%.CONCLUSION WZ capsules could significantly increase whole blood concentrations of tacrolimus.However,the blood concentration of tacrolimus decreased after 2 months and stabilized after 3 months of combined treatment.Thus it hints at a possibility of tolerance and attention should be paid to the changes of tacrolimus blood concentration at 2-3 months of combined use of WZ capsules to ensure the safety and effectiveness of treatment.