成年与老年肾移植受者霉酚酸药代动力学比较

摘要

目的：比较霉酚酸（MPA）在成年与老年肾移植受者药代动力学差异。方法采用高效液相色谱法监测成年组和老年组共21名肾移植术受者术后多剂量口服霉酚酸酯（MMF）达稳态后血液中MPA浓度，采用非房室模型计算MPA药动学参数，并进行组间比较。结果MPA达峰时间：成年（1.0±0.85）h，老年（1.38±1.02）h；峰浓度：成年（13.77±7.49）μg/mL，老年（9.80±6.46）μg/mL；药时曲线下面积AUC 0～12 h：成年（35.41±20.26）μg/(mL·h)，老年（21.62±8.15）μg/(mL·h)。成年组与老年组间峰浓度差异无统计学意义（P＞0.05）， AUC 0～12 h差异有统计学意义（P＜0.05）。结论MMF在体内的吸收有明显的差异；老年人的MMF生物利用度显著低于成年人，服用MMF需要适当增加剂量或缩短用药间隔。%Objective Comparing pharmacokinetic parameters of mycophenolic acid between adults and elderly people. Methods HPLC was used to monitor MPA concentration in blood of 21 renal transplantation recipients who divided into adult and elderly group after multiple doses of mycophenolate mofetil (MMF) after surgery. Non-compartment model was used to calculate MPA pharmacokinetic parameters after multiple doses until steady state. Pharmacokinetic parameters were compared between groups. Results Tmax:adult (1.0±0.85) h, elderly (1.38±1.02) h. Cmax:adult (13.77±7.49)μg/mL, elderly (9.80±6.46)μg/mL. AUC0~12h:adult (35.41±20.26)μg/(mL·h), elderly (21.62±8.15)μg/(mL·h). There is no significant dif erence in Cmax between adult and elderly, but there are significant dif erences in AUC0~12 h between adult and elderly. Conclusion There are significant dif erences in in-vivo absorption of MMF. The elderly`s bioavailability of MMF is lower than adult’s. Elderly should increase the dose or shorter dosing interval appropriately when taking MMF.