CAJ | 학술논문

目的：评价再生障碍性贫血（aplastic anemia，AA）患者环孢素A（Cyclosporine A，CsA）的血药浓度监测（therapeutic drug monitoring，TDM）和临床用药情况。方法：收集2004年1月—2015年2月我院AA患者CsA 血药浓度监测资料进行回顾性分析。结果：52例患者共监测CsA血药浓度426例次，其中达到有效血药浓度(150～250μg?L-1)145例次（34.0%）。患者首次监测时，低浓度结果占67.3%，随着监测次数增加，低浓度所占比例逐渐降低，而正常浓度和高浓度所占比例逐渐增加。本次分析还显示：CsA日剂量和CsA谷浓度有弱的正相关性；老年人达到和中青年人一样的血药浓度所需要的CsA日剂量少；合用伊曲康唑、克拉霉素可显著影响CsA的浓度。结论：CsA 血药浓度受很多因素的影响，分析显示：CsA剂量、年龄、性别、合并用药、TDM监测次数都可能对血药浓度有影响。除此之外，服药时间、采血时间、监测时是否已达稳态、食物、剂型、患者生理病理状态等都对其有影响。
목적：평개재생장애성빈혈（aplastic anemia，AA）환자배포소A（Cyclosporine A，CsA）적혈약농도감측（therapeutic drug monitoring，TDM）화림상용약정황。방법：수집2004년1월—2015년2월아원AA환자CsA 혈약농도감측자료진행회고성분석。결과：52례환자공감측CsA혈약농도426례차，기중체도유효혈약농도(150～250μg?L-1)145례차（34.0%）。환자수차감측시，저농도결과점67.3%，수착감측차수증가，저농도소점비례축점강저，이정상농도화고농도소점비례축점증가。본차분석환현시：CsA일제량화CsA곡농도유약적정상관성；노년인체도화중청년인일양적혈약농도소수요적CsA일제량소；합용이곡강서、극랍매소가현저영향CsA적농도。결론：CsA 혈약농도수흔다인소적영향，분석현시：CsA제량、년령、성별、합병용약、TDM감측차수도가능대혈약농도유영향。제차지외，복약시간、채혈시간、감측시시부이체은태、식물、제형、환자생리병리상태등도대기유영향。
Objective: To evaluate the therapeutic drug monitoring (TDM) and the clinical drug utilization of cyclosporine A (CsA) in aplastic anemia (AA) patients.Methods: TDM data of CsA in AA patients was collected and analyzed from January 2005 to February 2015.Results: Of 426 cases (52 subjects), 145 cases (34.0%) were within the therapeutic window. Among all the ifrst-tested TDM concentration, 67.3% of cases were below the therapeutic window. With the increasing number of TDM tests, the proportion of low concentration decreased, while the proportions of normal and high concentration increased. CsA dose and concentration of CsA had a weakly positive correlation. CsA concentration was higher in elderly people than in young people. Conclution:Concentration of CsA was affected by many factors. CsA dosage, age, sex, drug combination, TDM test times are likely to impact on CsA concentration. Various methods should be used to improve compliance rate, such as the use of drug-drug interactions.