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中国临床药理学与治疗学 ›› 1997, Vol. 2 ›› Issue (1): 45-47.

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肾移植术后受者环孢素的血药浓度监测

吴朝晖, 徐峰, 邹恒琴   

  1. 第一军医大学珠江医院,广州 510282
  • 收稿日期:1996-12-04 出版日期:1997-03-26 发布日期:2020-12-04
  • 作者简介:吴朝晖,女,30岁,主管药师,1989年毕业于中国药科大学。邹恒琴,男,54岁。主任药师,药材科主任。

Therapeutic drug monitoring of cyclosporine in Kidney-transplanted recipients

Wu Zhaohui, Xu Feng, Zou Hengqin   

  1. Department of Clinical Pharmacology, Zhujiang Hospital, First Military Medical University, Guangzhou 510282
  • Received:1996-12-04 Online:1997-03-26 Published:2020-12-04

摘要: 目的 观察环孢素血药浓度与肾移植效果间关系。方法 对97例接受同种异体肾脏移植术受者术后8周内206例次环孢素血药浓度监测结果进行回顾性分析,按照受者术后的临床表现、生化指标将其分为术后正常组、急性排斥组、急性毒性组,采用荧光偏振免疫测定法,以单克隆抗体试剂测定环孢素血药浓度。结果 术后正常组 62例移植肾功能良好,环孢素的给药剂量为5.2±1.9mg/kg·d,171例次环孢素血药浓度的平均值为309.85±131.69 μg/L;术后急性排斥组26例,距发生排斥反应最近一次的环孢素血药浓度平均为165.80±123.13μg/L,环孢素的给药剂量为4.8±1.6mg/kg·d;术后急性毒性组9例,距发生毒性反应最近一次的环孢素血药浓度平均为556.51±102.50μg/L,环孢素的给药剂量为6.2±1.0mg/kg·d。三组之间环孢素的给药剂量无显著性差异(P>0.05),但环孢素血药浓度却相差很大,两两之间有显著性差异(正常组与排斥组P<0.05;正常组与毒性组P<0.05;排斥组与毒性组P<0.01)。结论 环孢素浓度较低时,出现排斥反应的可能性较大;而环孢素浓度较高时,发生毒性反应的机会较多。

关键词: 环孢素, 治疗药物监测, 肾脏移植

Abstract: Aim To observe the relation between the blood cysclosporine concentration.Methods The therapeutic drug monitoring data of cyclosporine in 97 kidney-transplanted recipients in 8 weeks, from May 1995 to October 1996, were analysed retrospectively.The recipients were sorted in three groups,the normal group, the acute rejection group and the acute toxicity group.Blood cyclosporine concentration was measured by FPIA with monoclonal antibody reagent.Results In normal group, 62 recipients had good kidney function, with average daily dose of cyclosporine 5.2±1.9mg/kg·d, the blood concentration of cyclosporine was 309.85±131.69μg/L ;In acute rejection group, the average daily dose in 26 recipients was 4.8±1.6mg/kg·d, the blood concentration of cyclosporine pending rejection episode was 165.80±123.13μg/L;In acute toxicity group, the average daily.dose in 9 recipients was 6.2±1.0mg/kg·d, the cyclosporine blood concentration pending toxicity episode was 556.51±102.50μg/L.There was no sigificant difference among the three groups on the average daily dose of cyclosporine (P>0.05).However,the blood concentration of cyclosporine in three groups varied greatly and there was significant difference among them(P<0.05,even P<0.01 between acute rejection group vs toxicity group).Conclusion In therapeutic drug monotoring of cyclosporine measurement of blood drug concentration is extremely important.More acute rejection episodes occur with low blood concentration of cyclosporine, while more toxicity episodes happen with high blood concentration.

Key words: cyclosporine, therapeutic drug monitoring, kidney transplantation

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