Blood Concentration Monitoring and Clinical Application of Sirolimus in Children

Wang Yimeng; Ma Ailing; Zhao Ningmin; Ma Peizhi

doi:10.13407/j.cnki.jpp.1672-108X.2022.01.003

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Blood Concentration Monitoring and Clinical Application of Sirolimus in Children

更新时间：2022-11-03

- Blood Concentration Monitoring and Clinical Application of Sirolimus in Children
- Vol. 28, Issue 1, Pages: 10-13(2022)
- 作者机构：
  
  河南省人民医院,河南,郑州,450003
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2022.01.003
  CLC：
- Published：2022，
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Wang Yimeng, Ma Ailing, Zhao Ningmin, et al. Blood Concentration Monitoring and Clinical Application of Sirolimus in Children. [J]. 28(1):10-13(2022)
DOI：

Wang Yimeng, Ma Ailing, Zhao Ningmin, et al. Blood Concentration Monitoring and Clinical Application of Sirolimus in Children. [J]. 28(1):10-13(2022) DOI： 10.13407/j.cnki.jpp.1672-108X.2022.01.003.

摘要

目的：探讨西罗莫司在儿童患者中的血药浓度，考察血药浓度与相关实验室指标的关系，旨在为西罗莫司的合理应用提供更多的临床依据。方法：选择54例使用西罗莫司治疗的儿童患者，记录患者的基本信息、西罗莫司全血谷浓度（CSRL）、肝功能和中性粒细胞（NEU）等相关信息。结果：儿童患者西罗莫司血药浓度为（8.7±5.9）ng/mL，16.7%的患儿血药浓度<4 ng/mL，62.9%的患儿血药浓度为4~12 ng/mL，20.4%的患儿血药浓度>12 ng/mL。51.9%的患儿使用西罗莫司是用于治疗结节性硬化症，与治疗其他疾病相比，治疗该疾病时其西罗莫司血药浓度最低，为4.6（3.9）ng/mL；在用于治疗结节性硬化症时，60.7%患儿都有联合使用抗癫痫药物的情况，其中以联合丙戊酸的比例最高（57.1%）。天冬氨酸氨基转移酶（ALT）与CSRL呈正相关（r=0.458，P<0.05）。在血药浓度>12 ng/mL的患儿中，ALT、丙氨酸氨基转移酶（ALT）和NEU的结果异常率直线上升。结论：儿童患者在使用西罗莫司时，更加需要及时、定期的进行血药浓度、血常规和肝功能等指标的监测，充分施行个体化用药，以保证临床疗效。

Abstract

Objective: To probe into the blood concentration of sirolimus in children

and to investigate the correlation between blood concentration and related laboratory indicators

so as to provide more clinical evidence for the rational use of sirolimus. Methods: Fifty-four pediatric patients treated with sirolimus were enrolled

and the basic information

blood concentration of sirolimus (CSRL)

liver function and neutrophil (NEU) and other related information were recorded. Results: The blood concentration of sirolimus in children was (8.7±5.9) ng/mL

16.7% of the children with blood concentration of <4.0 ng/mL

62.9% of the children with blood concentration from 4.0 to 12.0 ng/mL

and 20.4 % of children with blood drug concentration >12.0 ng/mL. Sirolimus was used for tuberous sclerosis in 51.9% of children

with the lowest blood concentration of sirolimus 4.6 (3.9) ng/mL when compared with other diseases. In the treatment of tuberous sclerosis

60.7% of children were treated with antiepileptic drugs in combination

of which the proportion of drug combination of valproic acid was the highest (57.1%). Aspartate aminotransferase (AST) was positively correlated with CSRL (r=0.458

P<0.05). In children with blood concentration >12.0 ng/mL

there was a linear increase in the rate of abnormal AST

alanine aminotransferase (ALT) and NEU. Conclusion: When sirolimus is used in children

it is even more important to monitor the blood concentration

blood routine and liver function on a timely and regular basis to fully implement the individualized dosing to ensure clinical efficacy.

关键词

西罗莫司血药浓度监测儿童

Keywords

sirolimusblood concentration monitoringchildren

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