他克莫司血药浓度与肾病综合征的临床疗效相关性研究

Investigation on the Relationship between Tacrolimus Blood Concentration and Clinical Efficacy in Treatment of Nephrotic Syndrome Patients

关键词:  他克莫司  肾病综合征  血药浓度  临床疗效

Key words:  tacrolimus  nephritic syndrome  blood concentration  clinical efficacy

摘要:

目的 研究他克莫司治疗肾病综合征(NS)的临床疗效与其血药浓度的相关性。方法 34例 NS患者服用他克莫司达稳态血药浓度后，用酶增强免疫分析法(EMIT)测定他克莫司全血谷浓度，对患者进行随访，观察药物的治疗效果及不良反应，并应用统计学软件SPSS 13.0分析他克莫司血药浓度与临床疗效的相关性。结果 完全缓解(CR)组的血药浓度为(8.11±3.23)ng·mL^-1，部分缓解(PR)组的血药浓度为为(6.08±1.15)ng·mL^-1，无反应(NR)组为(3.25±0.96)ng·mL^-1，缓解率82.4%。他克莫司血药浓度与临床疗效进行Spearmen等级相关系数分析，rs=0.611>0.5>0，P<0.01，t(α/2)=0.01，呈正相关，相关性密切。结论 他克莫司治疗肾病综合征的临床疗效与血药浓度密切相关，他克莫司全血谷浓度在4.88~11.34 ng·mL^-1内，可达到满意的治疗效果。

Abstract:

OBJECTIVE To investigate the relationship between tacrolimus blood concentration and clinical efficacy in treatment of nephrotic syndrome patients. METHODS The blood valley concentration of tacrolimus in 34 cases of nephrotic syndrome patients was detected by enzyme multiplied immunoassay technique after tacrolimus plasma-drug concentration reached to steady state, then the therapeutic efficacy and adverse reactions were observed. The relationship between tacrolimus blood concentration and clinical efficacy was evaluated by SPSS 13.0. RESULTS The tacrolimus blood concentration was (8.11±3.23)ng·mL^-1 in group of CR, (6.08±1.15)ng·mL^-1 in group of PR, and (3.25±0.96)ng·mL^-1 in group of NR respectively. Remission rate was 82.4%. The relationship between clinical efficacy and tacrolimus blood concentration was analyzed by Spearmen correlation coefficients showed that it was positively correlated, and the correlation was closely[r_s=0.611>0.5>0, P<0.01, t(α/2)=0.01]. CONCLUSION The clinical efficacy of tacrolimus in the treatment of nephrotic syndrome is correlate to the blood concentrateion intimately, and in the range of 4.88-11.34 ng·mL^-1 of tacrolimus blood concentrateion, it can achieve satisfactory therapeutic efficacy to nephrotic syndrome patients.