Dalere G M, Lum B L, Cooney G F, Wong-Chin M
Department of Pharmacy, Veterans Affairs Medical Center, Palo Alto, California, USA.
Ther Drug Monit. 1995 Jun;17(3):305-7. doi: 10.1097/00007691-199506000-00015.
A method of therapeutic monitoring of cyclosporine by using area under the curve (AUC) has been previously proposed. However, different mathematical methods of calculating AUC may produce different results. We compared three methods of calculating whole blood 12-h AUC of cyclosporine A (CsA) at steady state in 16 pediatric renal allograft recipients. The linear trapezoidal method tended to significantly overestimate AUC when compared with a method combining linear and log trapezoidal methods, or the Lagrange technique combined with the logarithmic trapezoidal method, producing mean differences of 13.8 ngh/ml [95% confidence interval (CI), 7.3-20.3] and 12.8 ngh/ml [95% CI, 7.3-18.3], respectively. However, these differences appear to be of little clinical significance because they comprised < 1% of the calculated AUC value. The calculated AUCs by the three methods produced values with similar means and overlapping 95% CI. These data suggest that use of any of these three mathematical methods, when used to calculate CsA AUC for the determination of average steady-state concentrations and dose rate calculations, will produce similar results.
此前已提出一种通过曲线下面积（AUC）对环孢素进行治疗监测的方法。然而，不同的计算AUC的数学方法可能会产生不同的结果。我们比较了16例小儿肾移植受者在稳态下计算环孢素A（CsA）全血12小时AUC的三种方法。与线性和对数梯形法相结合的方法或拉格朗日技术与对数梯形法相结合的方法相比，线性梯形法往往会显著高估AUC，平均差异分别为13.8 ng·h/ml [95%置信区间（CI），7.3 - 20.3]和12.8 ng·h/ml [95% CI，7.3 - 18.3]。然而，这些差异似乎临床意义不大，因为它们占计算出的AUC值的不到1%。三种方法计算出的AUC值具有相似的均值和重叠的95% CI。这些数据表明，当使用这三种数学方法中的任何一种来计算CsA AUC以确定平均稳态浓度和剂量率计算时，将产生相似的结果。
