论文部分内容阅读
目的了解治疗免疫相关性血细胞减少症(IRP)过程中,环孢素A(CsA)血药浓度与疗效的关系。方法对2008年8月至2009年3月天津医科大学总医院血液科50例IRP患者CsA用药血药浓度及疗效进行分析。结果IRP患者空腹CsA血药浓度(C0)(141.3±97.0)μg/L;用药2 h后CsA血药浓度(C2)(437.2±241.9)μg/L。C2≥300μg/L的病例疗效、脱离血制品输注情况、髂骨骨髓增生情况均好于C2<300μg/L的病例。C0≥90μg/L患者的疗效、胸骨巨核数均好于C0<90μg/L的患者。应用CsA同时应用唑类抗真菌药物的病例血清尿素氮(BUN)升高的比例明显高于未用抗真菌药的患者。结论IRP患者CsA血药浓度与疗效相关,C2≥300μg/L及C0≥90μg/L疗效较好。CsA常规用量是安全的,并用唑类抗真菌药可引起肾损害。
Objective To understand the relationship between the plasma concentration of CsA and the therapeutic effect in the treatment of immune-related cytopenia (IRP). Methods From August 2008 to March 2009, the blood concentration of CsA in 50 patients with IRP in Department of Hematology, Tianjin Medical University General Hospital and its efficacy were analyzed. Results The fasting CsA concentration (C0) was 141.3 ± 97.0 μg / L in IRP patients and 437.2 ± 241.9 μg / L in CsA serum samples after 2 hours of treatment. C2 ≥ 300μg / L case efficacy, blood products from the infusion, iliac bone marrow hyperplasia were better than C2 <300μg / L cases. Efficacy of C0 ≥ 90μg / L patients, the number of sternomegalum were better than C0 <90μg / L patients. The proportion of serum urea nitrogen (BUN) increased with CsA plus azole antifungal agents was significantly higher than that without antifungal agents. Conclusion The plasma concentration of CsA in patients with IRP is related to the curative effect. The effect of C2≥300μg / L and C0≥90μg / L is better. CsA conventional dosage is safe, and use of anti-fungal azoles can cause kidney damage.