{"id":128713,"date":"2019-11-28T11:55:50","date_gmt":"2020-04-21T02:36:42","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/128713\/"},"modified":"2020-04-21T10:36:48","modified_gmt":"2020-04-21T02:36:48","slug":"146c2af357","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/128713\/","title":{"rendered":"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne dosage fits all\u300d say NO\uff01"},"content":{"rendered":"
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\u897f\u5b89\u4ea4\u901a\u5927\u5b66\u7b2c\u4e00<\/span>\u9644\u5c5e\u533b\u9662<\/span><\/p>\n<\/section>\n

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\u4e00\u7ea7\u4e3b\u4efb\u533b\u5e08\uff0c\u4e8c\u7ea7\u6559\u6388\uff0c\u535a\u58eb\u751f\u5bfc\u5e08\uff1b\u897f\u5b89\u4ea4\u901a\u5927\u5b66\u5668\u5b98\u79fb\u690d\u7814\u7a76\u6240\u6240\u957f\uff1b\u897f\u5b89\u4ea4\u901a\u5927\u5b66\u7b2c\u4e00\u9644\u5c5e\u533b\u9662\u80be\u810f\u75c5\u533b\u9662\u9662\u957f\uff1b\u4e2d\u534e\u533b\u5b66\u4f1a\u5668\u5b98\u79fb\u690d\u5b66\u5206\u4f1a\u5019\u4efb\u4e3b\u4efb\u59d4\u5458\uff1b\u4e2d\u56fd\u4eba\u4f53\u5668\u5b98\u6350\u732e\u4e0e\u79fb\u690d\u59d4\u5458\u4f1a\u59d4\u5458\uff1b\u4e2d\u56fd\u533b\u7597\u4fdd\u5065\u56fd\u9645\u4ea4\u6d41\u4fc3\u8fdb\u4f1a\u80be\u810f\u79fb\u690d\u5206\u4f1a\u4e3b\u4efb\u59d4\u5458\uff1b\u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u5668\u5b98\u79fb\u690d\u533b\u5e08\u5206\u4f1a\u526f\u4f1a\u957f\uff1b\u4e2d\u56fd\u751f\u7269\u533b\u5b66\u5de5\u7a0b\u5b66\u4f1a\u900f\u6790\u79fb\u690d\u5206\u4f1a\u526f\u4e3b\u4efb\u59d4\u5458\uff1b\u4e2d\u56fd\u7814\u7a76\u578b\u533b\u9662\u5b66\u4f1a\u79fb\u690d\u533b\u5b66\u5206\u4f1a\u526f\u4e3b\u4efb\u59d4\u5458<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u7ec8\u672b\u671f\u5668\u5b98\u75be\u75c5\u60a3\u8005\u71ac\u8fc7\u6f2b\u957f\u7684\u5668\u5b98\u7b49\u5f85\u671f\u540e\u7ec8\u4e8e\u8fce\u6765\u4e86\u65b0\u751f\uff1a<\/span><\/p>\n


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\u300c\u5668\u5b98\u79fb\u690d\u624b\u672f\u300d<\/span><\/strong><\/span><\/p>\n


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\u56e0\u6b64\u5f88\u591a\u5668\u5b98\u79fb\u690d\u53d7\u8005\u4f1a\u5c06\u624b\u672f\u8fd9\u4e00\u5929\u5b9a\u4e3a\u81ea\u5df1\u65b0\u7684\u300c\u751f\u65e5\u300d\uff0c\u5bf9\u65b0\u7684\u79fb\u690d\u5668\u5b98\u500d\u52a0\u73cd\u60dc\u3002<\/span><\/p>\n


<\/p>\n

\u7136\u800c\u81ea\u8eab\u7684\u514d\u75ab\u7cfb\u7edf\u53c8\u5c06\u8fd9\u5916\u6765\u7684\u300c\u5b9d\u8d1d\u300d\u89c6\u4e3a\u5f02\u7269\uff0c\u4f1a\u5bf9\u5176\u53d1\u52a8\u653b\u51fb\u800c\u53d1\u751f\u6392\u65a5\u53cd\u5e94\uff0c\u5668\u5b98\u79fb\u690d\u53d1\u5c55\u7684\u65e9\u671f\u9636\u6bb5\uff0c\u56e0\u4e3a\u6ca1\u6709\u6709\u6548\u7684\u514d\u75ab\u6291\u5236\u5242\uff0c\u79fb\u690d\u4e5f\u5e38\u5e38\u56e0\u6b64\u800c\u5931\u8d25\u3002<\/span><\/p>\n


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\u514d\u75ab\u6291\u5236\u5242<\/span><\/strong>\u5982\u73af\u5b62\u9709\u7d20\u3001\u5417\u66ff\u9ea6\u8003\u915a\u916f\u3001\u4ed6\u514b\u83ab\u53f8\u7b49\u7684\u51fa\u73b0\uff0c\u5927\u5927\u6539\u5584\u4e86\u8fd9\u4e00\u5c40\u9762\u3002<\/span><\/p>\n<\/section>\n

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\u5168\u7403\u7b2c\u4e00\u4e2a\u5417\u66ff\u9ea6\u8003\u915a\u9178\uff08MPA\uff09\u7c7b\u836f\u7269\u662f\u7f57\u6c0f\u516c\u53f8\u751f\u4ea7\u7684\u5417\u66ff\u9ea6\u8003\u915a\u9178\u916f\uff08MMF\uff0c\u5546\u54c1\u540d\uff1a\u9a81\u6089\uff09\u4e8e 1995 \u5e74\u7f8e\u56fd\u4e0a\u5e02\uff0c\u4f7f\u80be\u79fb\u690d\u53d7\u8005\u672f\u540e\u7b2c\u4e00\u5e74\u7684\u6025\u6027\u6392\u65a5\u53cd\u5e94\u53d1\u751f\u7387\u4ee5\u53ca\u79fb\u690d\u7269\u5931\u529f\u7387\u5927\u5927\u964d<\/span><\/span>\u4f4e<\/span>1<\/sup>\u3002\u6700\u65b0\u7684 2017 \u5e74\u7f8e\u56fd OPTN\/SRTR \u7684\u5e74\u62a5\u663e\u793a\uff1a\u80be\u79fb\u690d\u53d7\u8005\u672f\u540e 1 \u5e74\u5185\u7684\u6025\u6027\u6392\u65a5\u53cd\u5e94\u53d1\u751f\u7387\u4e3a 9%\uff0c\u672f\u540e 6 \u4e2a\u6708\u5185\u6765\u81ea\u4e8e\u6b7b\u4ea1\u4f9b\u4f53\u7684\u7684\u79fb\u690d\u80be\u7684\u4e22\u5931\u7387\u4e3a 4.3<\/span><\/span><\/span>%<\/span>2<\/sup>\u30022009 \u5e74\u8bfa\u534e\u516c\u53f8\u751f\u4ea7\u7684\u9ea6\u8003\u915a\u94a0\u80a0\u6eb6\u7247\uff08EC-MPS\uff0c\u5546\u54c1\u540d\uff1a\u7c73\u8299\uff09\u5728\u4e2d\u56fd\u4e0a\u5e02\u3002\u671f\u95f4\uff0c\u56fd\u5185\u4e5f\u6709\u8bf8\u591a MMF \u9646\u7eed\u4e0a\u5e02\u3002<\/span><\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u79fb\u690d\u672f\u540e\u6839\u636e\u73af\u5b62\u9709\u7d20\uff0c\u4ed6\u514b\u83ab\u53f8\u7b49\u7684\u6d53\u5ea6\u8c03\u6574\u5242\u91cf\u5df2\u7ecf\u6210\u4e3a\u5e38\u89c4\uff0c\u4f46 MPA \u7c7b\u836f\u7269\u76ee\u524d\u4ecd\u662f\u4ee5\u7ecf\u9a8c\u6027\u8c03\u6574\u5242\u91cf\u4e3a\u4e3b\uff0c\u90a3\u4e48\u662f\u4e0d\u662f\u771f\u7684\u4e0d\u9700\u8981\u5bf9\u6b64\u7c7b\u836f\u7269\u8fdb\u884c\u6d53\u5ea6\u76d1\u6d4b\u5462\uff1f<\/span>\u672c\u6587\u5c06\u5e26\u4f60\u4e00\u63a2\u7a76\u7adf\u3002<\/span><\/p>\n<\/section>\n

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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
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\u4e3a\u4ec0\u4e48 MPA-TDM\uff08MPA \u7684\u6cbb\u7597\u836f\u7269\u76d1\u6d4b\uff09\u52bf\u5728\u5fc5\u884c\uff1f<\/span><\/strong><\/p>\n<\/section>\n

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MPA \u7c7b\u836f\u7269\u7684\u4f5c\u7528\u673a\u5236\uff1a\u53e3\u670d MMF \u548c EC-MPS \u540e\u8fc5\u901f\u6c34\u89e3\u4e3a\u6709\u751f\u7269\u6d3b\u6027\u7684\u5417\u66ff\u9ea6\u8003\u915a\u9178\uff08MPA\uff09\uff0c\u800c MPA \u53ef\u5f3a\u6548\u5730\u3001\u9ad8\u5ea6\u9009\u62e9\u6027\u5730\u3001\u53ef\u9006\u5730\u548c\u975e\u7ade\u4e89\u5730\u6291\u5236\u6b21\u9ec4\u560c\u5464\u5355\u6838\u82f7\u9178\u8131\u6c22\u9176\uff08IMPDH\uff09\u7684\u6d3b\u6027\uff0c\u6709\u6548\u963b\u65ad\u6dcb\u5df4\u7ec6\u80de DNA \u548c RNA \u7684\u5408\u6210\uff0c\u4f7f\u7ec6\u80de\u589e\u6b96\u505c\u7559\u5728 S \u671f\u3002<\/span>\u56e0\u6b64\u5728\u7ec6\u80de\u6027\u6392\u65a5\u53cd\u5e94\u548c\u4f53\u6db2\u6027\u6392\u65a5\u53cd\u5e94\u4e2d\u5747\u53d1\u6325\u91cd\u8981\u4f5c\u7528\u3002<\/span><\/p>\n


<\/p>\n

\u4f46 MPA \u7c7b\u836f\u7269\u7684\u4e2a\u4f53\u5dee\u5f02\u6bd4\u8f83\u5927\uff0c\u6709\u6548\u6d53\u5ea6\u548c\u6bd2\u6027\u6d53\u5ea6\u4e4b\u95f4\u5dee\u5f02\u5c0f\uff0c\u5c5e\u4e8e\u7a84\u6cbb\u7597\u7a97\u836f\u7269\uff0c\u5176\u66b4\u9732\u6c34\u5e73\u4e0e\u6392\u65a5\u53cd\u5e94\u548c\u6bd2\u526f\u4f5c\u7528\u76f8\u5173\u3002<\/span><\/p>\n


<\/p>\n

\u5728\u5982\u4eca\u7cbe\u51c6\u533b\u7597\u53ca\u4e2a\u4f53\u5316\u6cbb\u7597\u65f6\u4ee3\uff0c\u300cOne dosage fits all\u300d\u5df2\u7ecf\u4e0d\u9002\u7528\u4e8e\u79fb\u690d\u53d7\u8005\u3002\u56fd\u9645\u79fb\u690d\u5b66\u4f1a\u4e8e 2011 \u5e74\u53d1\u8868\u4e86\u9488\u5bf9 MPA \u7c7b\u836f\u7269\u8fdb\u884c\u6d53\u5ea6\u76d1\u6d4b\u7684\u5171\u8bc6\uff08\u7f57\u9a6c\u5171\u8bc6<\/span>\uff09<\/span>3<\/sup> \u3002<\/span><\/p>\n<\/section>\n

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1. MPA \u66b4\u9732\u4e0e\u7597\u6548, \u6bd2\u526f\u4f5c\u7528\u5bc6\u4e0d\u53ef\u5206<\/span><\/strong><\/p>\n<\/section>\n

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\u300aTransplantation\u300b\u4e0a\u6700\u8fd1\u53d1\u8868\u7684\u4e00\u7bc7\u7efc\u8ff0\u7cfb\u7edf\u5206\u6790\u4e86 MPA-AUC \u4e0e\u6025\u6027\u6392\u65a5\u53cd\u5e94\u7684\u5173\u7cfb\uff0827 \u4e2a\u961f\u5217\uff0cN = 3794\uff09\u53ca\u6bd2\u526f\u4f5c\u7528\uff0822 \u4e2a\u961f\u5217,N = 3225\uff09\u7684\u5173\u7cfb\uff0c\u7ed3\u679c\u663e\u793a\uff08\u8868 1\uff09\uff1a<\/span><\/p>\n


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94.8% \u7684\u75c5\u4f8b\u663e\u793a MPA-AUC \u4e0e\u6025\u6027\u6392\u65a5\u53cd\u5e94\u663e\u8457\u76f8\u5173\u6216\u6709\u76f8\u5173\u8d8b\u52bf\u3002<\/span>\u5728 MPA \u4e0e\u4ed6\u514b\u83ab\u53f8\u8054\u7528\u548c\u6d4b\u5b9a\u4e86\u6e38\u79bb MPA \u6d53\u5ea6\u7684\u961f\u5217\u4e2d\uff0c\u5206\u522b\u6709 95.8% \u548c 100% \u7684\u75c5\u4f8b\u663e\u793a MPA-AUC \u4e0e\u6bd2\u526f\u4f5c\u7528\u663e\u8457\u76f8<\/span>\u5173<\/span>1<\/sup>\u3002<\/span><\/p>\n


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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
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\u8868 1 MPA-AUC \u4e0e\u6025\u6027\u6392\u65a5\u53cd\u5e94\u548c\u6bd2\u6027\u4e4b\u95f4\u7684\u5173\u7cfb<\/span><\/p>\n<\/section>\n

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\u968f\u673a\u5bf9\u7167\u7814\u7a76\u663e\u793a\uff0c\u53d7\u8005\u7684 MPA \u66b4\u9732\u6c34\u5e73\u4e0d\u540c\uff08\u4f4e\u3001\u4e2d\u3001\u9ad8\u66b4\u9732\u7ec4\u5e73\u5747 MPA-AUC \u5206\u522b\u4e3a 16.1 mg\u00b7h\/L\uff0c32.2 mg\u00b7h\/L\uff0c60.6 mg\u00b7h\/L\uff09\uff0cBPAR(\u7ecf\u6d3b\u68c0\u8bc1\u5b9e\u7684\u6025\u6027\u6392\u65a5\u53cd\u5e94) \u7684\u53d1\u751f\u7387\u4e0d<\/span>\u540c<\/span>4-5<\/sup> <\/sup>(\u5982\u56fe 1 \u6240\u793a)\u3002<\/span>\u5176\u4ed6\u4e09\u4e2a\u5927\u578b\u7684\u4e34\u5e8a\u7814\u7a76 (APOMYGRE \u7814\u7a76, FDCC \u7814\u7a76, OPTICEPT \u7814\u7a76) \u4e5f\u540c\u6837\u8bc1\u5b9e\u4e86 MPA \u66b4\u9732\u4e0e\u6025\u6027\u6392\u65a5\u53cd\u5e94\u663e\u8457\u76f8<\/span>\u5173<\/span>6-8<\/sup>\u3002<\/span><\/p>\n

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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
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\u56fe 1  BPAR \u4e0e MPA \u66b4\u9732\u7684\u5173\u7cfb<\/span><\/p>\n<\/section>\n

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\u4e00\u9879\u7eb3\u5165 125 \u4e2a\u80be\u79fb\u690d\u53d7\u8005\u7684\u4e34\u5e8a\u7814\u7a76\u7ed3\u679c\u8868\u660e\uff0cMPA \u66b4\u9732\u91cf\u7684\u8c37\u6d53\u5ea6\u4e2d\u4f4d\u503c\u589e\u52a0 1 mg\/mL\uff0c\u5c06\u660e\u663e\u589e\u52a0\u8d2b\u8840\u3001\u767d\u7ec6\u80de\u51cf\u5c11\u75c7\u3001\u8179\u6cfb\u4e0e\u75c5\u6bd2\u611f\u67d3\u7684\u6982\u7387\uff08\u8868 2<\/span>\uff09<\/span>9<\/sup>\u3002<\/span>\u53e6\u6709\u7814\u7a76\u663e\u793a\u5f53 MPA-AUC \u8d85\u8fc7 60 mg\u00b7h\/L \u65f6\u8d2b\u8840\u548c\u767d\u7ec6\u80de\u51cf\u5c11\u75c7\u53d1\u751f\u7387\u660e\u663e\u589e<\/span>\u591a<\/span>10<\/sup>\u3002<\/span><\/p>\n

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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
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\u8868 2 MPA \u6d53\u5ea6\u4e0e\u4e0d\u826f\u53cd\u5e94\u53d1\u751f\u98ce\u9669\u7684\u5173\u7cfb<\/span><\/p>\n<\/section>\n

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2. MPA \u7684\u836f\u4ee3\u52a8\u529b\u5b66\u5177\u6709\u8f83\u5927\u7684\u4e2a\u4f53\u5dee\u5f02<\/span><\/strong><\/p>\n<\/section>\n

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MPA \u7c7b\u836f\u7269\u7684\u4e2a\u4f53\u95f4\u836f\u4ee3\u52a8\u529b\u5b66\u5dee\u5f02\u53ef\u5728 10 \u500d\u4ee5\u4e0a\uff0c\u4e14 EC-MPS \u7684\u8c37\u6d53\u5ea6\u7684\u4e2a\u4f53\u5dee\u5f02\u9ad8\u4e8e MMF\uff0864% VS 24-42%<\/span>\uff09<\/span>11<\/sup>\u3002<\/span><\/p>\n<\/section>\n

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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
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\u7a76\u7adf\u662f\u54ea\u4e9b\u56e0\u7d20\u5f71\u54cd\u4e86 MPA \u7c7b\u836f\u7269\u7684\u836f\u7269\u4ee3\u8c22\u52a8\u529b\u5b66\u548c\u836f\u7269\u6548\u5e94\u52a8\u529b\u5b66\uff08PK\/PD\uff09\u5462\uff1f<\/span><\/strong><\/p>\n<\/section>\n

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1. \u6027\u522b\u3001\u79cd\u65cf\u548c\u4f53\u91cd<\/span><\/strong><\/p>\n<\/section>\n

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<\/p>\n<\/section>\n

\n

\u5bf9\u5065\u5eb7\u5fd7\u613f\u8005\u3001\u809d\u80be\u79fb\u690d\u53d7\u8005\u7b49\u4e0d\u540c\u7ec4\u53d7\u8bd5\u8005\u7684\u836f\u4ee3\u52a8\u529b\u5b66\u5b9e\u9a8c\u5ba4\u6570\u636e\u8868\u660e\uff0c\u6027\u522b\u5bf9 AUC \u7684\u5dee\u5f02\u65e0\u4e34\u5e8a\u610f<\/span>\u4e49<\/span>12<\/sup>\uff0c\u79cd\u65cf\u5dee\u5f02\u5bf9 MPA \u7684\u836f\u52a8\u5b66\u53c2\u6570\u65e0\u663e\u8457\u5f71\u54cd\uff0c\u800c\u4f53\u91cd\u5bf9 MPA \u548c MPAG \u7684\u836f\u52a8\u5b66\u53c2\u6570\u5747\u6709\u4e00\u5b9a\u5f71<\/span>\u54cd<\/span>13<\/sup>\u3002<\/span><\/p>\n


<\/p>\n

2.  \u80be\u810f\u6216\u809d\u810f\u635f\u4f24<\/span><\/span><\/strong><\/p>\n


<\/p>\n

\u4e25\u91cd\u80be\u529f\u80fd\u635f\u5bb3 (\u808c\u9150\u6e05\u9664\u7387<25 mL\/min) \u65f6\uff0c\u80be\u810f\u5bf9 MPAG \u7684\u6e05\u9664\u51cf\u5c11\uff0c\u5bfc\u81f4 MPAG \u6d53\u5ea6\u5347\u9ad8\uff0c\u8fdb\u800c\u53d6\u4ee3 MPA \u800c\u7ed3\u5408\u767d\u86cb\u767d\uff0c\u4f7f\u5f97\u6e38\u79bb MPA \u589e\u52a0\uff1b<\/span><\/span><\/span><\/p>\n


<\/p>\n

\u5982\u679c\u540c\u65f6\u80a0\u809d\u5faa\u73af\u53d7\u5230\u6291\u5236\u65f6\uff0c\u5219\u4f1a\u9020\u6210\u6e38\u79bb MPA \u589e\u52a0\uff0c\u800c\u603b\u7684 MPA \u548c\u7ed3\u5408\u7684 MPA \u7684\u66b4\u9732\u51cf\u5c11\u3002\u4f4e\u767d\u86cb\u767d\u8840\u75c7\u5f15\u8d77 MPA \u603b\u66b4\u9732\u4e0b\u964d\uff0c\u4f46\u4e0d\u5f71\u54cd\u6e38\u79bb MPA \u6d53\u5ea6\uff0c\u56e0\u6b64\u5728\u4e0a\u8ff0\u60c5\u51b5\u4e0b\u53ef\u68c0\u6d4b\u6e38\u79bb MPA \u6d53\u5ea6\u6765\u8bc4\u4f30 MPA \u7684\u66b4<\/span>\u9732<\/span>1<\/sup>\uff08\u56fe 2\uff09\u3002<\/span><\/span><\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

G<\/span>FR\uff1a\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387 EHC: \u80a0\u809d\u5faa\u73af<\/span><\/p>\n<\/section>\n

\n

\u56fe 2 \u4e0d\u540c\u751f\u7406\u6761\u4ef6\u4e0b\u6e38\u79bb MPA \u4e0e\u603b MPA \u7684\u66b4\u9732\u7684\u53d8\u5316<\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

3. \u836f\u7269\u76f8\u4e92\u4f5c\u7528<\/span><\/strong><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\n
\n
\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n

\u8d28\u5b50\u6cf5\u6291\u5236\u5242\uff08PPI\uff09\u7c7b\u836f\u7269\uff0c\u53ef\u5bfc\u81f4\u80c3\u5185 pH \u503c\u5347\u9ad8\uff0c\u964d\u4f4e MPA \u66b4<\/span>\u9732<\/span>3<\/sup>\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\n
\n
\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n

\u5927\u5242\u91cf\u7cd6\u76ae\u8d28\u6fc0\u7d20\u53ef\u964d\u4f4e MPA \u66b4<\/span>\u9732<\/span>3<\/sup>\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\n
\n
\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n

CsA \u53ef\u4f7f MPA \u6d53\u5ea6\u964d\u4f4e 30-40%, \u539f\u56e0\u53ef\u80fd\u662f\u7531\u4e8e CsA \u4f5c\u7528\u4e8e\u591a\u91cd\u8010\u836f<\/span>\u86cb\u767d 2<\/span>\uff08MRP2\uff09\u800c\u6291\u5236 MPAG\uff08\u65e0\u6d3b\u6027\uff0c\u4f46\u53ef\u5728\u80a0\u9053\u5fae\u751f\u7269\u7684\u4f5c\u7528\u4e0b\u8f6c\u6362\u4e3a MPA\uff09\u7684\u80a0\u809d\u5faa\u73af\u3002\u4ed6\u514b\u83ab\u53f8\u5bf9 MPA \u7684\u66b4\u9732\u65e0\u5f71<\/span>\u54cd<\/span>14<\/sup>\u3002<\/span><\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n


<\/p>\n<\/section>\n

\n

\u6572\u9ed1\u677f\uff01MPA \u7c7b\u836f\u7269\u4e4b\u95f4\u836f\u4ee3\u548c\u836f\u6548\u52a8\u529b\u5b66\uff08PK\/PD\uff09\u7684\u5dee\u5f02\u4e0d\u5bb9\u5ffd\u89c6\uff01<\/span><\/strong><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u4e34\u5e8a\u7814\u7a76\u8868\u660e\uff0cPK\/PD \u7684\u5dee\u5f02\u4e0d\u4ec5\u4ec5\u662f\u7531\u4e8e\u5236\u5242\u7c7b\u578b\u4e0d\u540c\uff0c\u5982 MMF \u4e0e EC-MPS \u7684\u5dee\u5f02\uff0c\u540c\u65f6\u4e5f\u5e7f\u6cdb\u5b58\u5728\u4e8e\u76f8\u540c\u5242\u578b\u7684 MPA \u7c7b\u836f\u7269\u4e2d\u3002<\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u4e0d\u540c\u5242\u578b\u95f4\u5dee\u5f02\u786e\u5b9e\u5b58\u5728<\/strong><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u6709\u5173\u7a33\u5b9a\u671f\u7684\u80be\u79fb\u690d\u53d7\u8005\u7684\u4e34\u5e8a\u7814\u7a76\u8868\u660e\uff1a\u7531\u4e8e EC-MPS \u662f\u5728\u5c0f\u80a0\u5185\u6c34\u89e3\u4e3a MPA\uff0c\u56e0\u6b64\u5176\u5438\u6536\u6548\u7387\u4f9d\u8d56\u4e8e\u80c3\u6392\u7a7a\uff0c\u8fbe\u5cf0\u65f6\u95f4\u6bd4 MMF \u5e73\u5747\u665a\u4e86\u4e00\u500d\uff0c\u4e14\u4e2a\u4f53\u5dee\u5f02\u66f4\u5927\u4e14\u8fd9\u79cd\u5dee\u5f02\u5e76\u4e0d\u968f\u7740\u79fb\u690d\u540e\u65f6\u95f4\u7684\u63a8\u79fb\u5f97\u5230\u6539\u5584\uff0c\u800c\u8fd9\u79cd\u5dee\u5f02\u5728\u8f6c\u6362\u4e3a MMF \u540e\u53ef\u5f97\u5230\u660e\u663e\u6539\u5584\uff08\u56fe 3\uff09\u3002<\/span>\u80a0\u6eb6\u7247\u8f83\u9ad8\u836f\u4ee3\u52a8\u529b\u5b66\u7684\u53d8\u5f02\u6027\u4f7f\u5f97\u7528 EC-MPS \u65f6 MPA-TDM \u6bd4 MMF \u66f4\u5177\u6311\u6218\u6027\uff0c\u5cf0\u8c37\u6ce2\u52a8\u503c\u4e5f\u663e\u793a MMF \u66f4\u7a33\u5b9a\uff0c\u6bd4 EC-MPS \u6d53\u5ea6\u6ce2\u52a8\u4f4e\u7ea6 20%\u3002MMF \u4ea7\u751f\u66f4\u53ef\u9760\u7684\u836f\u4ee3\u52a8\u529b\u5b66\u7279\u5f81 <\/span>11\uff0c12\uff0c15\uff0c16<\/sup>\uff08\u8868 3\uff09\u3002<\/span><\/p>\n

<\/span><\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u56fe 3 \u4e0d\u540c MPA \u4e4b\u95f4 AUC \u7684\u5dee\u5f02<\/span><\/p>\n<\/section>\n

\n


<\/p>\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u8868 3 MMF \u548c EC-MPS \u4e4b\u95f4\u7684 PK\/PD \u7684\u5dee\u5f02<\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u57fa\u4e8e\u6d53\u5ea6-\u65f6\u95f4\u57fa\u7840\u7684\u7fa4\u4f53\u836f\u4ee3\u52a8\u529b\u5b66\u7814\u7a76\u5206\u6790\u4e86\u4e03\u9879\u4e34\u5e8a\u7814\u7a76\u5171 259 \u4e2a\u80be\u79fb\u690d\u53d7\u8005\uff0c\u7ed3\u679c\u663e\u793a\u4f7f\u7528 EC-MPS \u6cbb\u7597\u7684\u53d7\u8005\u7684 MPA \u5438\u6536\u7387\u4f4e\u4e8e MMF\u3002\u800c\u4e14 EC-MPS \u7684\u5438\u6536\u534a\u8870\u671f\u957f\u4e8e MMF(0.23 h vs 0.17 h), EC-MPS \u7684\u591c\u95f4\u5438\u6536\u4e5f\u66f4\u6162\uff0c\u4e5f\u5bfc\u81f4\u4e86\u5728\u68c0\u6d4b MPA-TDM \u65f6\uff0c\u6668\u8d77\u670d\u836f\u524d\u7684 MPA \u6d53\u5ea6\u8981\u9ad8\u4e8e MM<\/span>F<\/span>16<\/sup>\u3002<\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u76f8\u540c\u5242\u578b\u540c\u6837\u5b58\u5728\u5dee\u5f02<\/strong><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u4e00\u9879\u5355\u4e2d\u5fc3\u3001\u968f\u673a\u3001\u5f00\u653e\u6807\u7b7e\u30014 \u79cd\u4e0d\u540c\u54c1\u724c\u7684 MMF\uff08\u5370\u5ea6\u516c\u53f8\u751f\u4ea7\u7684 Renodapt\u3001Mycept\u3001mune \u548c\u745e\u58eb\u7f57\u6c0f\u516c\u53f8\u751f\u4ea7\u7684 Cept\uff09\u30014 \u4e2a\u5468\u671f\u30014 \u4e2a\u5e8f\u5217\u7684\u4ea4\u53c9\u7814\u7a76<\/span>17<\/sup>\uff0c\u5171\u7eb3\u5165 32 \u4f4d 18-55 \u5c81\u5065\u5eb7\u7537\u6027\u53d7\u8bd5\u8005\uff0c\u5bf9 4 \u79cd MMF \u5c55\u5f00\u836f\u4ee3\u52a8\u529b\u5b66\u5206\u6790\uff0c\u4ee5 Cept \u4e3a\u53c2\u6bd4\u5236\u5242\uff0c\u8bc4\u4f30 MPA \u7c7b\u836f\u7269\u5728\u4f53\u5185\u7684\u5dee\u5f02\u3002\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff1a<\/span>
<\/p>\n


<\/p>\n<\/section>\n

\n
\n
\n
\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n

\u76f8\u540c\u5242\u578b\u7684\u4e0d\u540c\u836f\u7269 MPA-AUC \u5728 24 \u5c0f\u65f6\u5185\u65e0\u660e\u663e\u5dee\u5f02\uff0c \u4f46 6 \u5c0f\u65f6\u5185\u5dee\u5f02\u663e\u8457\uff08\u56fe 4\uff09<\/span><\/span>\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\n
\n
\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n

\u4e0d\u540c MMF \u4ea7\u751f\u7684 MPA \u7684 C<\/span>max<\/sub>\u548c T<\/span>max<\/sub>\u7b49\u836f\u52a8\u5b66\u53c2\u6570\u5b58\u5728\u660e\u663e\u5dee\u5f02\uff0cC<\/span>max<\/sub>\u7684\u6bd4\u503c\u8d85\u51fa\u6807\u51c6\u8303\u56f4\uff0c\u751a\u81f3\u672a\u8fbe\u5230\u751f\u7269\u7b49\u6548\u6027\u6807\u51c6\uff08\u8868 4 \u548c\u8868 5\uff09<\/span><\/span><\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\n
\n
\n
<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n

\u76f8\u540c\u5242\u578b\u7684\u6eb6\u89e3\u66f2\u7ebf\u4e5f\u5b58\u5728\u663e\u8457\u5dee\u5f02\uff08\u56fe 5\uff09\u3002<\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u56fe 4 \u56db\u79cd\u836f\u7269 0-48 \u5c0f\u65f6\u5185\u7684 MPA-AUC \u76f8\u4f3c\uff0c\u4f46 0-6 \u5c0f\u65f6\u5185\u6709\u660e\u663e\u5dee\u5f02<\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u8868 4  \u76f8\u540c\u5242\u578b\u7684\u4e0d\u540c\u836f\u7269\u4ea7\u751f\u7684 MPA \u836f\u52a8\u5b66\u53c2\u6570\u5dee\u5f02\u660e\u663e<\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u8868 5  \u76f8\u540c\u5242\u578b\u4e0d\u540c\u836f\u7269\u4ea7\u751f\u7684 MPA \u95f4\u5bf9\u6bd4\u8d85\u51fa\u6807\u51c6\u8303\u56f4<\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u56fe 5 \u56db\u79cd\u836f\u7269\u7684\u6eb6\u51fa\u66f2\u7ebf<\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u603b\u4e4b\uff0c\u751f\u7269\u7b49\u6548\u6027\u8bd5\u9a8c\u5e76\u4e0d\u80fd\u4fdd\u8bc1\u60a3\u8005\u5728\u66f4\u6362\u540c\u7c7b\u540c\u5242\u578b\u7684\u836f\u7269\u540e\u6cbb\u7597\u7ed3\u679c\u5177\u6709\u6301\u7eed\u6027\uff0c\u8fd9\u4e00\u70b9\u503c\u5f97\u5f15\u8d77\u4e34\u5e8a\u533b\u751f\u7684\u6ce8\u610f\uff01<\/span><\/p>\n


<\/p>\n

\u7f8e\u56fd\u79fb\u690d\u534f\u4f1a\uff0c\u56fd\u9645\u5fc3\u80ba\u79fb\u690d\u534f\u4f1a, KDIGO \u7b49\u6743\u5a01\u673a\u6784\u8868\u793a\u5728\u540c\u79cd\u7c7b\u836f\u7269\u7684\u4e0d\u540c\u54c1\u724c\u7684\u836f\u7269\u4e4b\u95f4\u5207\u6362\u65f6\u5e94\u8c28\u614e\u5e76\u4e25\u683c\u7ba1<\/span>\u7406<\/span>18-20<\/sup>\u3002<\/span><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n
\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n


<\/p>\n<\/section>\n

\n

\u6709\u54ea\u4e9b\u503c\u5f97\u63a8\u8350\u7684 MPA-TDM \u76d1\u6d4b\u65b9\u6cd5\uff1f<\/span><\/strong><\/p>\n<\/section>\n

\n


<\/p>\n<\/section>\n

\n

\u76ee\u524d\uff0cMPA \u6d53\u5ea6\u7684\u68c0\u6d4b\u65b9\u6cd5\u6709 HPLC\uff08\u9ad8\u6548\u6db2\u76f8\u8272\u8c31\u6cd5\uff09\u548c EMIT\uff08\u9176\u589e\u5f3a\u514d\u75ab\u5206\u6790\u6cd5\uff09\uff0cHPLC \u6cd5\u51c6\u786e\u5ea6\u548c\u7279\u5f02\u6027\u597d\u4f46\u64cd\u4f5c\u590d\u6742\uff0c EMIT \u6cd5\u7b80\u4fbf\uff0c\u4f46\u7ed3\u679c\u9ad8\u7ea6 10\uff5e20%\u3002<\/span><\/p>\n


<\/p>\n

\u800c\u8bc4\u4f30 MPA-AUC \u7684\u65b9\u6cd5\u6839\u636e\u91c7\u6837\u70b9\u53ef\u4ee5\u5206\u4e3a\u5168\u70b9\u91c7\u6837\u6cd5\uff08Full-AUC\uff09,  \u6709\u9650\u91c7\u6837\u6cd5\uff08LSS\uff09\u548c\u5355\u70b9\u91c7\u6837\u6cd5\u3002<\/span><\/p>\n


<\/p>\n

\u76ee\u524d\u6700\u5e38\u7528\u548c\u53ef\u884c\u7684\u662f LSS \u6cd5\uff0c\u91c7\u7528\u8d1d\u53f6\u65af\u6cd5\u6216\u591a\u5143\u7ebf\u6027\u56de\u5f52\u65b9\u7a0b\u4f30\u7b97 MPA \u7684 AUC\u3002\u4f46\u7f57\u9a6c\u5171\u8bc6\u660e\u786e\u6307\u51fa\u8be5\u65b9\u6cd5\u4e0d\u9002\u7528\u4e8e EC-MPS\uff0c\u539f\u56e0\u662f\u65e2\u5f80\u7684\u8ba1\u7b97\u516c\u5f0f\u548c MPA-AUC 30-60mg.h\/L \u7684\u53c2\u8003\u8303\u56f4\u90fd\u662f\u57fa\u4e8e MMF \u7684\u4e34\u5e8a\u7814<\/span>\u7a76<\/span>3<\/sup>\u3002<\/span><\/p>\n


<\/p>\n

2016 \u5e74\u7684\u7814\u7a76\u4e5f\u663e\u793a\uff1a\u5982\u679c\u91c7\u7528 6 \u5c0f\u65f6\u5185 LSS \u6cd5\u68c0\u6d4b MPA-AUC\uff0c\u4f7f\u7528 EC-MPS \u7684\u4eba\u7fa4\u7684\u68c0\u6d4b\u5931\u8d25\u7387\u9ad8\u8fbe 35%\uff0c\u539f\u56e0\u53ef\u80fd\u662f EC-MPS \u5ef6\u8fdf\u5438\u6536\u5bfc\u81f4\u7684\u8c37\u6d53\u5ea6\u7684\u589e\u9ad8\u548c\u5cf0\u503c\u7684\u5ef6<\/span>\u8fdf<\/span>21<\/sup>\u3002<\/span><\/p>\n<\/section>\n

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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
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\u56fe 6 MPA \u6d53\u5ea6\u7684\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u65b9\u6cd5<\/span><\/p>\n<\/section>\n

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\"\u79fb\u690d\u53d7\u8005\uff0c\u5bf9\u300cOne<\/section>\n<\/section>\n
\n

\u56fe 7 MMF \u548c EC-MPS \u7684 LSS \u6cd5\u68c0\u6d4b\u7684\u5931\u8d25\u7387<\/span><\/p>\n<\/section>\n

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\n

\u603b\u7684\u6765\u8bf4\uff0c\u76ee\u524d\u56fd\u5185\u5916\u5df2\u5bf9 MPA \u7c7b\u836f\u7269\u7684 PK\/PD \u548c\u6d53\u5ea6\u7684\u76d1\u6d4b\u5f00\u5c55\u4e86\u5927\u91cf\u7684\u79d1\u5b66\u7814\u7a76\uff0c\u5176\u7ed3\u679c\u5747\u63ed\u793a\u4e86\u8be5\u7c7b\u836f\u7269\u5728\u60a3\u8005\u4f53\u5185\u663e\u8457\u7684\u4e2a\u4f53\u5dee\u5f02\uff0c\u4ee5\u53ca MPA \u7684\u66b4\u9732\u6c34\u5e73\u548c\u4e34\u5e8a\u7597\u6548\u53ca\u6bd2\u526f\u4f5c\u7528\u663e\u8457\u76f8\u5173\u3002<\/span><\/p>\n


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\u56e0\u6b64\u662f\u65f6\u5019\u548c\u56fa\u5b9a\u5242\u91cf\u7684\u7ecf\u9a8c\u7528\u836f Say No \u4e86\uff0c\u800c\u5e94\u8be5\u6839\u636e\u836f\u7269\u7684\u6d53\u5ea6\u8fdb\u884c\u4e2a\u4f53\u5316\u7528\u836f\u3002\u800c\u4e14\u7814\u7a76\u663e\u793a\u4e0d\u540c\u5242\u578b\u7684 MPA \u7c7b\u836f\u7269\u53ca\u76f8\u540c\u5242\u578b\u7684 MMF \u4e4b\u95f4\u7684 PK\/PD \u4e5f\u662f\u5b58\u5728\u5dee\u5f02\u7684\u3002\u79fb\u690d\u53d7\u8005\u4f53\u5185\u73af\u5883\u590d\u6742\uff0c\u5b58\u5728\u591a\u79cd\u5408\u5e76\u7528\u836f\uff0c\u800c\u5728\u5065\u5eb7\u4eba\u7fa4\u4e2d\u8fdb\u884c\u7684\u751f\u7269\u7b49\u6548\u6027\u7814\u7a76\u4e0d\u80fd\u51c6\u786e\u53cd\u5e94\u79fb\u690d\u53d7\u8005\u4f53\u5185\u7684\u72b6\u51b5\u3002<\/span><\/p>\n


<\/p>\n

\u6240\u4ee5\u5728\u7cbe\u51c6\u533b\u7597\u7684\u5927\u80cc\u666f\u4e0b\uff0c\u4e3a\u4e86\u6700\u5927\u7a0b\u5ea6\u7684\u4fdd\u8bc1\u60a3\u8005\u7528\u836f\u7684\u6709\u6548\u6027\u4e0e\u5b89\u5168\u6027\uff0c\u4e34\u5e8a\u533b\u751f\u5728\u4f7f\u7528\u6216\u66f4\u6362 MPA \u7c7b\u836f\u7269\u65f6\u5e94\u5f53\u5c24\u5176\u91cd\u89c6\u6f5c\u5728\u7684\u6392\u65a5\u98ce\u9669\u5e76\u8bc4\u4f30 MPA-TDM \u7684\u53ef\u884c\u6027\u548c\u65b9\u4fbf\u6027\uff0c\u4fdd\u6301\u836f\u7269\u6cbb\u7597\u7684\u4e00\u81f4\u6027\u548c\u5e73\u7a33\u6027\u3002<\/span><\/p>\n<\/section>\n

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\u8d23\u4efb\u7f16\u8f91\uff1aTina<\/span><\/p>\n

\u9898\u56fe\u53ca\u6587\u7ae0\u4e2d\u914d\u56fe\u6765\u6e90 | \u7ad9\u9177\u6d77\u6d1b\u521b\u610f<\/span><\/p>\n<\/section>\n

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\u53c2\u8003\u6587\u732e<\/p>\n

1. Metz D K, Holford N, Kausman J Y, et al. Optimizing Mycophenolic Acid Exposure in Kidney Transplant Recipients: Time for Target Concentration Intervention[J]. Transplantation, 2014, 103(10).<\/span><\/span><\/span><\/p>\n

2. A. Hart, J. M. Smith, M. A. Skeans et al, OPTN\/SRTR 2017 Annual Data Report: Kidney. Am J Transplant. 2019 Feb;19 Suppl 2:19-123.<\/span><\/span><\/span><\/span><\/p>\n

3. Le Y M, Borrows R, Pescovitz M D, et al. Therapeutic drug monitoring of mycophenolates in kidney transplantation: report of The Transplantation Society consensus meeting[J]. Transplantation reviews (Orlando, Fla.), 2011, 25(2): 58-64.<\/span><\/span><\/span><\/span><\/span><\/p>\n

4. Hale M D, Nicholls A J, Bullingham R E S, et al. The pharmacokinetic\u2010pharmacodynamic relationship for mycophenolate mofetil in renal transplantation[J]. Clinical Pharmacology & Therapeutics, 1998, 64(6): 672-683.<\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

5. Van Gelder T, Hilbrands L B, Vanrenterghem Y, et al. A randomized double-blind, multicenter plasma concentration controlled study of the safety and efficacy of oral mycophenolate mofetil for the prevention of acute rejection after kidney transplantation1[J]. Transplantation, 1999, 68(2): 261-266.<\/span><\/p>\n

6. Le Meur Y, B\u00fcchler M, Thierry A, et al. Individualized mycophenolate mofetil dosing based on drug exposure significantly improves patient outcomes after renal transplantation[J]. American Journal of Transplantation, 2007, 7(11): 2496-2503.<\/span><\/span><\/p>\n

7. van Gelder T, Silva H T, de Fijter J W, et al. Comparing mycophenolate mofetil regimens for de novo renal transplant recipients: the fixed-dose concentration-controlled trial[J]. Transplantation, 2008, 86(8): 1043-1051.<\/span><\/span><\/span><\/p>\n

8. Gaston R S, Kaplan B, Shah T, et al. Fixed\u2010or controlled\u2010dose mycophenolate mofetil with standard\u2010or reduced\u2010dose calcineurin inhibitors: the Opticept trial[J]. American Journal of Transplantation, 2009, 9(7): 1607-1619.<\/span><\/span><\/span><\/span><\/p>\n

9. Borrows R, Chusney G, Loucaidou M, et al. Mycophenolic acid 12\u2010h trough level monitoring in renal transplantation: association with acute rejection and toxicity[J]. American journal of transplantation, 2006, 6(1): 121-128.<\/span><\/span><\/span><\/span><\/span><\/p>\n

10. Kuypers D R J, de Jonge H, Naesens M, et al. Current target ranges of mycophenolic acid exposure and drug-related adverse events: a 5-year, open-label, prospective, clinical follow-up study in renal allograft recipients[J]. Clinical therapeutics, 2008, 30(4): 673-683.<\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

11. Dario Cattaneo, Monica Cortinovis, Sara Baldelli et al. Pharmacokinetics of Mycophenolate Sodium and Comparison with the Mofetil Formulation in Stable Kidney Transplant Recipients. Clin J Am Soc Nephrol. 2007 Nov;2(6):1147-55.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

12. \u5417\u66ff\u9ea6\u8003\u915a\u916f\u80f6\u56ca\uff08\u9a81\u6089\uff09\u836f\u7269\u8bf4\u660e\u4e66.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

13. van Gelder T, Hesselink D A. Mycophenolate revisited[J]. Transplant International, 2015, 28(5): 508-515.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

14. Griny\u00f3 J M, Ekberg H, Mamelok R D, et al. The pharmacokinetics of mycophenolate mofetil in renal transplant recipients receiving standard-dose or low-dose cyclosporine, low-dose tacrolimus or low-dose sirolimus: the Symphony pharmacokinetic substudy[J]. Nephrology Dialysis Transplantation, 2009, 24(7): 2269-2276.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

15. \u9ea6\u8003\u915a\u94a0\u80a0\u6eb6\u7247\uff08\u7c73\u8299\uff09\u836f\u7269\u8bf4\u660e\u4e66.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

16. de Winter B C, Van G T, Glander P, et al. Population pharmacokinetics of mycophenolic acid : a comparison between enteric-coated mycophenolate sodium and mycophenolate mofetil in renal transplant recipients[J]. 2008, 47(12):827-838.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

17. Reigner B, Grange S, Bentley D, et al. Generics in transplantation medicine: Randomized comparison of innovator and substitution products containing mycophenolate mofetil[J]. International journal of clinical pharmacology and therapeutics, 2019, 57(10): 506.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

18. Alloway R R, Isaacs R, Lake K, et al. Report of the American Society of Transplantation conference on immunosuppressive drugs and the use of generic immunosuppressants[J]. American Journal of Transplantation, 2003, 3(10): 1211-1215.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

19. Uber P A, Ross H J, Zuckermann A O, et al. Generic drug immunosuppression in thoracic transplantation: an ISHLT educational advisory[J]. The Journal of heart and lung transplantation, 2009, 28(7): 655-660.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

20. Kasiske B L, Zeier M G, Chapman J R, et al. KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary[J]. Kidney international, 2010, 77(4): 299-311.<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

21. <\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>Hougardy J M, Maufort L, Cotton F, et al. Therapeutic drug monitoring of enteric-coated mycophenolate sodium by limited sampling strategies is associated with a high rate of failure[J]. Clinical kidney journal, 2016, 9(2): 319-323.<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section><\/div>\n","protected":false},"excerpt":{"rendered":"

\u4f5c\u8005\u7b80\u4ecb \u897f\u5b89\u4ea4\u901a\u5927\u5b66\u7b2c\u4e00\u9644\u5c5e\u533b\u9662 \u859b\u6b66\u519b\u6559\u6388 \u4e00\u7ea7\u4e3b\u4efb\u533b\u5e08\uff0c\u4e8c\u7ea7\u6559\u6388\uff0c\u535a\u58eb\u751f\u5bfc\u5e08\uff1b\u897f\u5b89\u4ea4\u901a\u5927\u5b66\u5668\u5b98\u79fb\u690d\u7814\u7a76\u6240 […]<\/p>\n","protected":false},"author":1,"featured_media":128714,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[2],"tags":[],"_links":{"self":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/128713"}],"collection":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/comments?post=128713"}],"version-history":[{"count":1,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/128713\/revisions"}],"predecessor-version":[{"id":128734,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/128713\/revisions\/128734"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media\/128714"}],"wp:attachment":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media?parent=128713"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/categories?post=128713"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/tags?post=128713"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}