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目的:探讨骨髓移植患者术后环孢素A(CsA)有效血药浓度临床治疗的有效性与安全性。方法:采用免疫分析法,对14例骨髓移植患者术后1~466 d全血谷浓度进行监测,共216例/次,并对监测结果进行分析。结果:慢性粒细胞性白血病、急性非淋巴细胞白血病、急性淋巴细胞白血病、地中海贫血、全血细胞减少症患者术后CsA的有效血药浓度范围分别为50~450、100~450、100~350、200~500、250~500 ng·mL~(-1)。骨髓移植术后7例出现排斥反应,其谷浓度为67.4~189.34 ng·mL~(-1)(平均125.44±39.56 ng·mL~(-1));3例发生不良反应,其谷浓度为412.5~548.62 ng·mL~(-1)(平均481.39±68.08 ng·mL~(-1))。结论:及时监测患者的CsA血药浓度,调整用药方案,可避免排斥反应和不良反应的发生,对确保患者用药安全、有效具有重要意义。
Objective: To investigate the effectiveness and safety of clinical treatment of CsA effective blood concentration in patients after bone marrow transplantation. Methods: Immunoassay was used to monitor the whole blood concentration of cerebrospinal fluid from 1 to 466 days postoperatively in 14 patients with bone marrow transplantation (216 cases / time), and the monitoring results were analyzed. Results: The effective plasma concentrations of CsA in patients with chronic myelogenous leukemia, acute non-lymphocytic leukemia, acute lymphoblastic leukemia, thalassemia and pancytopenia ranged from 50 to 450, from 100 to 450, from 100 to 350, respectively. 200 ~ 500, 250 ~ 500 ng · mL ~ (-1). The rejection occurred in 7 patients after bone marrow transplantation, and the trough concentrations were 67.4-189.34 ng · mL -1 (mean 125.44 ± 39.56 ng · mL -1). The adverse reactions occurred in 3 patients. The trough concentrations were 412.5 ~ 548.62 ng · mL ~ (-1) (average 481.39 ± 68.08 ng · mL -1). Conclusion: It is of great significance to ensure the safety and effectiveness of medication in patients by timely monitoring the concentration of CsA in patients and adjusting the dosage regimen to avoid rejection and adverse reactions.