553例次异基因造血干细胞移植受者全血环孢素浓度监测结果分析

目的：分析异基因造血干细胞移植（ allogeneic hematopoietic stem cell transplantation ， allo-HSCT ）患者全血中环孢素A （CsA）浓度变化的可能影响因素，探讨治疗药物监测对于确保患者合理用药的临床意义。方法采用荧光偏振免疫（FPIA）法测定患者全血CsA浓度，收集79例allo-HSCT患者使用CsA后的临床资料，统计分析CsA血药浓度和临床表现、生化指标之间的关系。结果79例患者553次CsA血药浓度测定结果平均为（307．51±169．11）μg·L^-1，其中血药浓度在150～600μg· L^-1范围内者447例次（80．8％）、低于150μg· L^-1者67例次（12．1％），高于600μg· L^-1者39例次（7．0％）。初步相关分析结果表明CsA血药浓度与间接胆红素、血清镁有较强的相关性，与其他生化指标的相关性不明显。结论 CsA血药浓度受多种因素的影响，对allo-HSCT患者进行CsA浓度监测具有重要的临床意义。

Cyclosporine blood concentration in 553 cases allogeneic hematopoietic stem cell transplant recipients

Objective To analyze factors which may affect cyclosporine A （ CsA） blood concentrations of allogeneic hematopoietic stem cell transplantation （allo-HSCT） patients,and to investigate the clinical significance of therapeutic drug monitoring to ensure the rational use of drugs in patients .Methods We determined CsA blood concentrations by fluorescence polarization immunoassay （ FPIA ） method.Clinical data of seventy-nine cases of allo-HSCT patients were collected after use of cyclosporine ,then the relationship among CsA blood concentrations and clinical manifestations ,biochemical parameters was analyzed .Results The average determination of 553 tests of CsA blood concentrations in 79 patients was（307.51 ±169.11） μg· L^-1,of which 447（80.8%）CsA blood concentrations were within the range from 150 μg· L^-1 to 600 μg· L^-1 ,67（12.1%） less than 150 μg· L-1 ,and 39（7.0%） higher than 600 μg· L^-1 .Preliminary analysis results showed that there was a strong correlation among the CsA concentration ,indirect bilirubin and serum magnesium,while the correlation with other biochemical indexes was not obvious .Conclusions CsA blood concentration is influenced by many factors .There is important clinical significance in monitoring CsA blood concentration in allo -HSCT patients .