儿童患者西罗莫司血药浓度监测及临床应用分析

目的:探讨西罗莫司在儿童患者中的血药浓度,考察血药浓度与相关实验室指标的关系,为西罗莫司的合理应用提供更多的临床依据.方法:选择54例使用西罗莫司治疗的患儿,记录基本信息、西罗莫司全血谷浓度(CSRL)、肝功能和中性粒细胞计数(NEU)等相关信息.结果:儿童患者西罗莫司血药浓度为(8.7±5.9) ng/mL,16.7...

Blood Concentration Monitoring and Clinical Application of Sirolimus in Children

Abstract] Objective: To probe into the blood concentration of sirolimus in children, and to investigate the correlation between blood concentration and related laboratory indicators, so as to provide more clinical evidence for the rational use of sirolimus. Methods: Fifty-four pediatric patients treated with sirolimus were enrolled, and the basic information, blood concentration of sirolimus (CSRL), liver function and neutrophil (NEU) and other related information were recorded. Results: The blood concentration of sirolimus in children was (8.7±5.9) ng/mL, 16.7% of the children with blood concentration of <4.0 ng/mL, 62.9% of the children with blood concentration from 4.0 to 12.0 ng/mL, and 20.4 % of children with blood drug concentration >12.0 ng/mL. Sirolimus was used for tuberous sclerosis in 51.9% of children, with the lowest blood concentration of sirolimus 4.6 (3.9) ng/mL when compared with other diseases. In the treatment of tuberous sclerosis, 60.7% of children were treated with antiepileptic drugs in combination, of which the proportion of drug combination of valproic acid was the highest (57.1%). Aspartate aminotransferase (AST) was positively correlated with CSRL (r=0.458, P<0.05). In children with blood concentration >12.0 ng/mL, there was a linear increase in the rate of abnormal AST, alanine aminotransferase (ALT) and NEU. Conclusion: When sirolimus is used in children, it is even more important to monitor the blood concentration, blood routine and liver function on a timely and regular basis to fully implement the individualized dosing to ensure clinical efficacy.