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目的探讨性别对肾移植患者霉酚酸酯(MMF)药代动力学的影响。方法纳入肾移植科手术患者178例。当体内药物浓度到达稳态后,于服药后0.5,1.5,4和9 h取患者静脉血,用高效液相色谱法测定血浆中MMF代谢物霉酚酸(MPA)和葡萄糖醛酸霉酚酸(MPAG)浓度,估算0~12 h血药浓度-时间曲线下面积(AUC0-12 h)。结果女性剂量调整MPA AUC0-12 h(46.24±2.98)mg·h·L-1·g-1,显著高于男性的(35.36±1.61)mg·h·L-1·g-1(P<0.01);而MPAG/MPA女性(15.24±1.05)显著低于男性(18.68±0.87)(P<0.05)。此外,女性年龄与剂量调整MPA AUC0-12 h呈负相关(P<0.05),45岁以下年龄组的剂量调整MPA AUC0-12h(49.74±3.58)mg·h·L-1·g-1,显著高于45岁以上年龄组的(33.69±2.49)mg·h·L-1·g-1(P<0.05)。结论在中国肾移植患者中,MMF体内代谢存在性别差异,且女性体内药物代谢与年龄相关。
Objective To investigate the effect of gender on mycophenolate mofetil (MMF) pharmacokinetics in renal transplant recipients. Methods 178 cases of renal transplantation patients. When the in vivo drug concentration reached the steady state, venous blood was taken at 0.5, 1.5, 4 and 9 h after taking the drug, and the plasma concentrations of MMF metabolites mycophenolic acid (MPA) and glucuronic acid mycophenolic acid (MPAG) concentration, the area under the plasma concentration-time curve (AUC0-12 h) from 0 to 12 h was estimated. Results The female dose adjusted MPA AUC of 0.12 h (46.24 ± 2.98) mg · h · L-1 · g-1, which was significantly higher than that of males (35.36 ± 1.61 mg · h-1 · g-1, P < 0.01). The MPAG / MPA women (15.24 ± 1.05) were significantly lower than those of men (18.68 ± 0.87) (P <0.05). In addition, the age of women was negatively correlated with dose-adjusted MPA AUC0-12 h (P <0.05), and the dose of MPA AUC0-12 h (49.74 ± 3.58) mg · h · L-1 · g-1 was adjusted in age group below 45 years old, (33.69 ± 2.49) mg · h · L-1 · g-1 (P <0.05) in the group over 45 years old. Conclusion There are gender differences in the metabolism of MMF in Chinese kidney transplant patients, and the drug metabolism in the female is related to age.