Khảo sát nồng độ tacrolimus máu trên bệnh nhân ghép tim tại bệnh viện Việt Đức=Survey of blood Tacrolimus concentration on heart transplant patients at Viet Duc hospital

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Tác giả: Thị Hòa Đặng, Thị Mai Dung Đỗ, Tùng Hoàng, Kim Dần Nguyễn, Phương Anh Phạm, Thảo Diệp Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.110-117

Bộ sưu tập: Báo, Tạp chí

ID: 243941

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Khảo sát nồng độ Tacrolimus (Tac) máu ở bệnh nhân sau ghép tim tại bệnh viện Việt Đức. Đối tượng và phương pháp: 42 bệnh nhân ghép tim được theo dõi nồng độ đáy của Tacrolimus (concentration Tac: Co Tac) trong máu toàn phần sau ghép. Nghiên cứu được thực hiện tại các thời điểm sau ghép: trong 1 tháng đầu, 2-3 tháng, 4-6 tháng, 7 -12 tháng. Nồng độ Tac trong máu toàn phần được đo trên máy Architech i2000 SR (Hoa Kỳ) theo nguyên lý miễn dịch hóa phát quang. Nghiên cứu hồi cứu kết hợp tiến cứu. Kết quả: Nồng độ CoTac máu qua các thời điểm lần lượt là 10,02±2,36
9,69±2,82
9,48±2,67
8,48±2,13 ng/mL. Hệ số biến thiên tương ứng là 38,24%
23,60%
23,48%
25,11%. Có 22 bệnh nhân có hệ biến thiên CoTac máu ở mức thấp với Co Tac máu trung bình 8,92±2,11 ng/mL và số bệnh nhân tử vong là 1/22. Có 20 bệnh nhân có hệ số biến thiên Co Tac máu ở mức cao với giá trị trung bình là 9,96±1,63 ng/mL và số bệnh nhân tử vong là 5/20. Nồng độ Co Tac máu có mối tương quan thuận với kháng thể kháng HLA dương tính, AST (GOT), ALT (GPT), và Creatinin máu
tương quan nghịch với mức lọc cầu thận (GFR). Kết luận: Nồng độ Co Tac máu giảm dần theo từng giai đoạn nghiên cứu, hệ số biến thiên cao nhất tại thời điểm một tháng đầu tiên sau ghép và nồng độ Co Tac máu trung bình ở nhóm có độ biến thiên cao cao hơn so với nhóm có độ biến thiên thấp. Hệ số biến thiên giữa từng cá thể là khác nhau.To investigate blood Tacrolimus (Tac) concentration in post-heart transplant patients at Viet Duc Hospital. Subjects and Methods: 42 heart transplant patients were monitored for trough Tacrolimus concentration (Co Tac) in whole blood post-transplantation. The study was conducted at specific posttransplant intervals: within the first month, 2-3 months, 4-6 months, and 7-12 months. Whole blood Tac concentration were measured using the Architech i2000 SR (USA) based on the chemiluminescent immunoassay principle. The study combined retrospective and prospective analysis. Results: The Co Tac blood concentration at each interval were 10,02±2,36
9,69±2,82
9,48±2,67 and 8,48±2,13ng/mL, respectively. The corresponding coefficients of variation were 38,24%
23,60%
23,48%
and 25,11%. 22 patients exhibited low variability in Co Tac blood levels with an average Co Tac of 8,92±2,11 ng/mL and a mortality rate of 1/22. 20 patients exhibited high variability in Co Tac blood levels with an average Co Tac of 9,96±1,63 ng/mL and a mortality rate of 5/20. Co Tac blood levels were positively correlated with positive anti-HLA antibodies, AST (GOT), ALT (GPT), and blood Creatinine levels
negatively correlated with glo merular filtration rate (GFR).Conclusion: Co Tac blood levels decreased over the study periods, with the highest variability observed in the first month post-transplant. The average of Co Tac blood concentrations in the high variability group was higher than in the low variability group. Variability coefficients is varied among individuals.

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