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目的:分析骨髓移植患者术后,环孢素(CsA)血药浓度及临床治疗的有效性和安全性。方法:采用荧光偏振免疫分析方法对39例骨髓移植受试者术后1～466d的526例次全血CsA谷浓度进行监测分析,并观察CsA临床疗效和不良反应等。结果:17例慢性粒细胞白血病受试者的220例次CsA有效血浓度为60～450ng·ml~(-1);7例急性非淋巴细胞性白血病受试者125例次为:100～500ng·ml~(-1);2例急性淋巴细胞性白血病受试者为:100～300ng·ml~(-1);10例再生障碍性贫血受试者112例次全血谷值浓度为:75～400ng·ml~(-1);3例地中海贫血受试者术后进行的49例次为:150～500ng·ml~(-1)。其中8例出现排斥反应的谷值浓度为18.60～251.20 ng·ml~(-1);10例受试者出现药物不良反应的谷值浓度为306.70～578.7ng·ml~(-1);结论:跟踪监测骨髓移植术后受试者不同时间段CsA血药浓度,及时调整用药方案,可减少排斥反应和药物不良反应的发生。
Objective: To analyze the efficacy and safety of cyclosporin (CsA) in patients after bone marrow transplantation and its clinical efficacy. Methods: Fluorescence polarization immunoassay was used to monitor the concentration of 526 cases of whole blood CsA in 39 bone marrow transplant recipients from 1 to 466 days after operation. The clinical efficacy and adverse reactions of CsA were observed. Results: The blood concentration of CsA in 220 cases of 60 patients with chronic myelogenous leukemia was 60 ~ 450ng · ml -1. The number of 125 patients with acute non-lymphocytic leukemia was 100 ~ 500ng · Ml ~ (-1); 2 cases of acute lymphoblastic leukemia subjects: 100 ~ 300ng · ml ~ (-1); 10 cases of aplastic anemia 112 cases of sub-total blood cereal concentration: 75 ~ 400ng · ml ~ (-1); three cases of thalassemia subjects were followed up for 49 times: 150 ~ 500ng · ml ~ (-1). The trough concentration of rejection in 8 cases was 18.60 ~ 251.20 ng · ml ~ (-1). The trough concentration of drug adverse reactions in 10 subjects was 306.70 ~ 578.7 ng · ml ~ (-1). Conclusion : Tracking and monitoring of CsA blood concentration in different time periods after bone marrow transplantation in patients with timely adjustment of drug regimens can reduce the incidence of rejection and adverse drug reactions.