CAJ | 학술논문

目的：动态监测肾移植患者环孢素 A血药浓度，为临床安全、合理用药提供参考。方法回顾性分析73例成人肾移植患者1033例次环孢素A血药浓度谷值的监测资料。结果有805例次（占77.93%）达到有效血药浓度(100～400 ng/mL )；有182例次（占17.62%）低于有效血药浓度(<100 ng/mL )，其中64例出现急性排斥反应，根据CsA谷浓度的监测结果及时调整给药剂量，排斥反应得以缓解；有46例次(占4.45%)超过有效血药浓度(？400 ng/mL )，其中27例次表现为不同程度的中毒症状，如恶心、呕吐、震颤和头痛等，根据CsA谷浓度的监测结果及时调整给药剂量，中毒症状得以缓解。结论及时监测患者CsA谷浓度，并根据监测结果调整CsA的给药剂量和给药时间间隔，合理制订个体化给药方案，可避免毒性反应和排斥反应的发生，提高患者用药安全性，减少不良反应的发生。
목적：동태감측신이식환자배포소 A혈약농도，위림상안전、합리용약제공삼고。방법회고성분석73례성인신이식환자1033례차배포소A혈약농도곡치적감측자료。결과유805례차（점77.93%）체도유효혈약농도(100～400 ng/mL )；유182례차（점17.62%）저우유효혈약농도(<100 ng/mL )，기중64례출현급성배척반응，근거CsA곡농도적감측결과급시조정급약제량，배척반응득이완해；유46례차(점4.45%)초과유효혈약농도(？400 ng/mL )，기중27례차표현위불동정도적중독증상，여악심、구토、진전화두통등，근거CsA곡농도적감측결과급시조정급약제량，중독증상득이완해。결론급시감측환자CsA곡농도，병근거감측결과조정CsA적급약제량화급약시간간격，합리제정개체화급약방안，가피면독성반응화배척반응적발생，제고환자용약안전성，감소불량반응적발생。
Objective To dynamically monitor the blood concentrations of cyclosoprine A ( CsA ) in renal transplant patients to provide reference for clinical safe and rational medication. Methods The monitoring data from 1 033 cases-times of cyclosporine A blood val-ley concentration in 73 cases of adult renal transplant were performed the retrospective analysis. Results 805 case-times reached the effective blood concentration ( 100-400 ng/mL ) , accounting for 77. 93% of the total number;182 case-times were lower than the ef-fective blood concentration (< 100 ng/mL ) , accounting for 17. 62% of the total number, including 64 case of acute rejection reaction, after timely adjusting CsA dose according to the monitoring results, the rejection reaction was alleviated;46 case-times exceeded the effective blood concentration ( ? 400 ng/mL ) , accounting for 4. 45% of the total number, including 27 case-times showed varying de-grees of toxic symptoms, such as nausea, vomiting, tremor and headache, the CsA dose was timely adjusted according to the monitoring results and the toxic symptoms were finally relieved. Conclusion Timely monitoring blood valley concentrations, adjusting the CsA dose and administration interval, and rationally formulating the individualized medication regimen can avoid the occurrence of toxic reactions and rejection reactions, increase the medication safety and reduce the occurrence of adverse reactions.