目的:为临床药动学采样点优化研究提供参考.方法:以“贝叶斯估计”“贝叶斯反馈法”“有限采样”“优化采样,,“稀疏采样”“最小采样”和“Bayesian estimate (s)”“Bayesian estimator(s)”“Bayesian analysis"“Limited sampling”“Optimal sampling”“Sparsesampling”“Minimal sampling”等为检索词,组合查询2011年1月-2016年6月在中国知网、万方、维普和PubMed、Medline、ScienceDirect等数据库中有关药动学采样点优化研究方面的文献,并对其进行系统分析与评价.结果:最终纳入中文文献1篇、英文文献13篇.有关临床药动学采样点优化研究方面的药物,主要集中在免疫抑制剂、抗病毒药物、抗菌药物和儿童个体化用药等领域.目前,关于临床药动学优化采样策略的研究方法国内仍较多采用多元线性回归法(MLR),国外已广泛应用最大后验贝叶斯法(MAPB).MLR方程简便易用,但对采样点要求十分严格;MAPB法可应用较少采样点完成,且对采样时间要求少,更适于临床实践,但需要应用专业软件完成.两种方法精密度和准确度大致相同.优化采样策略的研究方法差异较大,但均包含获取先验信息、确定参考值、优化采样点、验证预测能力4个步骤.结论:MAPB法结果准确、可靠,且对采样点要求更少,更符合临床实践需要,适用于临床药动学优化采样研究.%OBJECTIVE:To provide reference for the study of optimal sampling points in clinical pharmacokinetics.METHODS:The literatures about optimal sampling points in clinical pharmacokinetics were searched from CNKI,Wanfang database,VIP,PubMed,Medline,ScienceDirect and other databases during Jan.2011-Jun.2016 using "Bayesian estimate(s)""Bayesian estimator(s) Bayesian analysis" "Limited" "Optimal" "Sparse" "Minimal sampling" as retrieval words.The systematic analysis and evaluation were conducted.RESULTS:A total of 1 Chinese literature and 13 English literatures were involved respectively.The drugs they focused on were mainly immunosuppressive agents,antiviral drugs,antibiotics,pediatric individualized medication,etc.Multiple linear regression (MLR) was still the most widely used method in China,while maximum a posteriori Bayesian (MAPB) method was more popular in foreign studies.MLR equation was simple and easy to use,but the sampling was very strict.MAPB method could be completed with less sampling points and sampling time;it was more suitable for clinical practice,but needed professional software.The precision and accuracy of the two methods were similar.The research methods of optimal sampling strategy were quite different but all included 4 steps as prior information ganining,reference value determination,sampling point optimization,prediction capability verification.CONCLUSIONS:MAPB method requires less sampling points and it results are relatively accurate and reliable.It is more suitable for clinical practice and optimal sampling study of clinical pharmacokinetics.
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