| 摘要: |
| 目的:分析无锡市儿童医院开展他克莫司和环孢素治疗药物监测(TDM)出现的危急值相关临床资料,结合临床实践评
估其应用效果,提升用药安全性。方法:统计分析2016—2024 年他克莫司和环孢素TDM 中出现的危急值发生率、科室、标本转
运时间和报告时间等。结果:共监测药物2 307 例,出现危急值21 例(0. 9%),其中他克莫司14 例,环孢素7 例。他克莫司出
现危急值的科室主要集中在儿科重症监护室(21. 4%,3/ 14),主要诊断为肺移植术后(42. 9%,6/ 14);环孢素则全部在血液
科,临床诊断均为再生障碍性贫血。14 例患儿经减量后再次检测恢复至正常范围。他克莫司出现危急值的标本平均转运时
间和报告时间分别为89. 5 min 和306. 5 min,环孢素标本平均转运时间和报告时间分别为134 min 和401 min。结论:TDM 能
有效识别他克莫司和环孢素的血药浓度危急值风险,对肺移植及再生障碍性贫血患儿具有重要价值,通过及时干预可显著
改善用药安全性。 |
| 关键词: 他克莫司 环孢素 治疗药物监测 危急值 儿童 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2025.12.008 |
|
| 基金项目:无锡市市级临床重点专科项目,编号2023SZD-YXB;无锡市儿童医院博士科研启动基金,编号2023BSQD-ZKZ;无锡市科学技术
协会软科研究课题,编号KX-24-C038。 |
|
| Retrospective Analysis of Critical Values in Therapeutic Drug Monitoring for Immunosuppressants in aGrade Ⅲ, Level A Children’s Hospital |
| Hao Wanli1, Zhu Kouzhu2, Li Yu2, Wang Yan2, Liu Xiaoping1 |
| (1. College of Pharmacy, Wannan Medical College, Anhui
Wuhu 241002, China; 2. Affiliated Children’s Hospital of Jiangnan University, Wuxi Children’s Hospital, Jiangsu Wuxi 214023,
China) |
| Abstract: |
| Objective: To analyze the clinical data related to critical values generated from therapeutic drug monitoring (TDM) of
tacrolimus and cyclosporine in Wuxi Children’s Hospital, and to evaluate the application effect based on clinical practice, so as to
enhance the medication safety. Methods: The incidence, departments, turnaround time and reporting time of critical values generated
from TDM of tacrolimus and cyclosporine from 2016 to 2024 were statistically analyzed. Results: Among 2,307 TDM tests performed, 21
critical values (0. 9%) were detected, with 14 cases in tacrolimus and 7 cases in cyclosporine. Critical values for tacrolimus were
predominantly observed in the Pediatric Intensive Care Unit (21. 4%, 3/ 14), with the main diagnosis of post-lung transplantation
(42. 9%, 6/ 14). Critical values for cyclosporine was all administered in the Hematology Department, all the patients were clinically
diagnosed with aplastic anemia. Following dosage adjustment, therapeutic drug concentrations were successfully normalized in 14 patients
upon repeat testing. The mean turnaround time and reporting time for samples with critical values of tacrolimus were respectively 89. 5
and 306. 5 min, while those for cyclosporine were respectively 134 and 401 min. Conclusion: TDM can effectively identify the critical
value risks of tacrolimus and cyclosporine blood concentrations, holding significant value particularly for lung transplant recipients and
aplastic anemia patients. Timely intervention can markedly enhance medication safety. |
| Key words: tacrolimus cyclosporine therapeutic drug monitoring critical values children |
