Analysis of Blood Concentration Monitoring of Sirolimus and Adverse Drug Reaction in Renal Transplantation Patients / 中国药学杂志

ABSTRACT

OBJECTIVE: In those patients by monitoring and analyzing the whole blood concentrations of sirolimus of 410 cases of patients underwent kidney transplant, To provide guidance for the reasonable utilization of medications. METHODS: Chemiluminescence microparticles immuno assay (CMIA) was used to determine the whole blood concentrations of sirolimus of 42 patients (410 cases) in the First Affiliated Hospital of Zhengzhou University hospital, from January 2013 to March 2015 years. Then the relationships between the whole blood concentrations of sirolimus and ALT, AST, T-CHO, TG or platelet count were analyzed. RESULTS: In our study, the average whole blood concentration of sirolimus of 410 cases was (5.6±2.9) ng·mL-1, ranging from 1.02 to 22.85 ng·mL-1. Three hundred and six cases got concentrations of 4~8 ng·mL-1, accounted for 74.6%. 46 cases(11.2%)got concentrations less than 4 ng·mL-1 and 58 cases with concentrations more than 8 ng·mL-1 accounted for 14.2%. The whole blood concentration of sirolimus of those patients showed positive correlations with ALT, AST, T-CHO, TG(P <0.05) and negative correlation with platelet count(r=-0.231, P<0.05). Patients with abnormal blood drug concentration may be related to compliance, diet, blood volume, genotype, combination and individual differences. CONCLUSION: With a narrow therapeutic window, individualized dosage regimens need to be adopted and the blood concentration of which should be monitored when sirolimus was used. Close attention should be paid to the concentration of blood fat, and the blood concrentration of sirolimus need timely adjustment to guarantee a considerable efficacy and reduce the incidence of adverse reactions.