国产环孢素新老剂型对重症肌无力患者血药谷浓度的影响

目的:了解环孢素新老剂型对重症肌无力患者血药谷浓度的影响。方法:回顾性分析环孢素剂型更换前后189例重症肌无力患者的病案、用药记录以及血药浓度检测结果。结果:环孢素血药谷浓度随着每日用药剂量的增加稳步升高;微乳剂环孢素血药谷浓度与测定浓度前日最后一次服药剂量相关,油剂环孢素血药谷浓度与测定浓度前一日服药剂量相关;剂型改变(微乳剂与油剂)对患者血药谷浓度影响差别不大;临床上,根据体重计算两种剂型环孢霉素服用剂量意义不大,其中微乳剂相对于油剂更不适用mg·kg-1换算环孢素用量。结论:环孢素微乳剂逐渐代油剂,如何合理有效的进行剂型转换对重症肌无力疾病的治疗有重要意义。

Effects of different formulations of cyclosporine A on trough blood concentration in patients with myasthenia gravis

AIM: To evaluate the effects of different formulations of cyclosporine A on trough blood concentration in patients with myasthenia gravis. METHODS: Retrospectively analyzed the medical documents and information on medications and drug monitoring data of 189 myasthenia gravis patients admitted during the period of the transversion of cyclosporine A formulation. RESULTS: The trough blood concentration of cyclosporine A increased with the increase of medication dosage, and the microemulsified formulation was related to the last dose of cyclosporine A while the oil-based formulation was related to the last day dosage of cyclosporine A. No statistical difference of trough blood concentration was observed between the two formulations, weight was little meaningful for the calculation of cyclosporine A dosage, especially in the case of microemulsified form. CONCLUSION: The conversion from oil-based formulation to microemulsified formulation is the clinical trend, but it is very important to utilize the newer one in the efficient and reasonable way for the treatment of myasthenia gravis.