【作者】 周雅君； 张秀贤； 钱文璟；

【Author】 Yajun Zhou;Xiuxian Zhang;Wenjing Qian;Pharmacy department of Shenzhen Second People’s hospital, shenzhen;

【机构】 深圳市第二人民医院药学部；

【摘要】 目的:针对我院2017年1～12月期间进行6种治疗药物监测(TDM)的结果进行回顾性分析,探讨本院治疗药物监测在临床的应用价值。方法:利用西门子Viva·E血药浓度检测仪、均相酶放大免疫分析法(EMIT)测定他克莫司、环孢素、卡马西平、丙戊酸、甲氨蝶呤、万古霉素6种药物的血药浓度,对测定结果进行分析和总结。结果:2017年我院监测例数和测定频率最多的是免疫抑制剂他克莫司,占我院所有监测品种次数的50.22%,其次是环孢素,其监测比例为21.90%,其他依次为丙戊酸13.42%、甲氨蝶呤7.85%、万古霉素4.00%、卡马西平2.59%。他克莫司监测主要集中在肾病及各类移植术后,环孢素、甲氨蝶呤监测主要集中在血液相关疾病,丙戊酸、卡马西平主要集中在神经内科相关疾病。移植术后抗排斥治疗中需要密切监测药物疗效和调整药物剂量,患者血药浓度稳定相应的监测周期增长,血药浓度波动较大则监测频度增加。结论:开展血药浓度监测,能有效减少药源性疾病的发生,展现患者用药的有效情况,给医生调整患者用药提供有效的参考依据,保证患者用药安全有效。更多还原

【Abstract】 Objective:From January to December 2017, 6 kinds of results of therapeutic drug monitoring(TDM) were retrospectively analyzed in our hospital to explore the value of therapeutic drug monitoring in clinical practice.Methods:By using Viva·E and homogeneous enzyme immunoassay amplification(EMIT),the blood concentration of 6 kinds of drugs including tacrolimus,cyclosporine,carbamazepine, valproic acid, methotrexate, vancomycin were detected respectively.The measurement results were analyzed and summarized.Results:Immunosuppressant tacrolimus had the most monitoring patients and the highest measuring frequency,accounting for 50.22% in the hospital for all monitoring species number,followed by cyclosporine,that is 21.90%, carbamazepine is 2.59%, valproic acid is 13.43%, methotrexate is 7.85%, vancomycin is 4.0%.Tacrolimus monitoring is mainly focused on renal disease and various types of post-transplant, cyclosporin and methotrexate monitoring are mainly focused on blood related diseases, valproic acid and carbamazepine are mainly focused on related diseases in neurology. In the anti-rejection treatment after transplantation, drug efficacy and drug dose should be closely monitored. The blood drug concentration of the patients was stable and corresponding monitoring cycle increased, while the monitoring frequency increased if the blood drug concentration fluctuated significantly.Conclusion:The development of blood drug concentration monitoring can reduce the occurrence of drug induced diseases,improve the quality of life in patients with epilepsy and ensure the safety of patients effectively.更多还原