摘要
免疫抑制药他克莫司在心脏、肝、肾和肺移植治疗中起着至关重要的作用,是移植后早期器官受者的首选免疫抑制药物,对提高器官移植患者的生存率具有重要贡献。但是他克莫司治疗窗窄,血药浓度个体间和个体内变异大,血药浓度的影响因素较多,给临床用药带来较大挑战。该文概述了人口生物学因素、移植时间和移植器官的类型、基因多态性、合并用药、食物和药物剂型对他克莫司血药浓度的影响,以及人口生物学因素与基因多态性相互关系。CYP3A4、CYP3A5基因及合并用药是影响他克莫司血药浓度的主要因素,可为临床器官移植患者他克莫司的治疗药物监测和剂量调整提供参考。
The immunosuppressant tacrolimus has played a crucial role in the treatment of heart,liver,kidney and lung transplantation.It is the first choice of immunosuppressive drugs for organ recipients in the early stage after organ transportation,which has contributed significantly to improve the survival rate of organ transplant patients.However,the narrow therapeutic window of tacrolimus,the great inter-individual and intra-individual variation of blood drug concentration,and many influencing factors of blood drug concentration bring great challenges to clinical medication.This paper summarizes the effects of population biology,time and the type of the transplanted organ transplantation,gene polymorphisms and drug combination,food and drug dosage form on blood concentration of tacrolimus.Population biological factors are related to gene polymorphism,CYP3A4,CYP3A5 gene and drug combination is the main factor of tacrolimus blood concentrations,which provide reference for the detection and dose adjustments of tacrolimus in clinical organ transplant patients.
作者
吴云
王家莹
卢映蓉
段茹
WU Yun;WANG Jiaying;LU Yingrong;DUAN Ru(Drug Clinical Trial Department, Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)
出处
《医药导报》
CAS
北大核心
2022年第5期669-674,共6页
Herald of Medicine
基金
国家自然科学基金资助项目(81904055)。
关键词
他克莫司
器官移植
血药浓度
Tacrolimus
Organ transplant
Blood concentration
作者简介
吴云(1995-),女,安徽六安人,药师,硕士,研究方向:药学,ORCID:0000-0001-7655-3988,电话:0510-85350347,E-mail:2029284415@qq.com;通信作者:段茹(1987-),女,山西运城人,主管药师,硕士,专业方向:临床药理学、医学伦理、药物浓度监测,电话:0510-85351101,E-mail:duanruwuxi@163.com。
