郑师明,司徒冰,谭湘萍,卢敏妍
ZHENG Shi-ming,SITU Bing,TAN Xiang-ping,LU Minyan(Dept.of Pharmacy

• 1:广州医学院第三附属医院药剂科
• 2:广州医学院第三附属医院药剂科
• 3:广州医学院第三附属医院药剂科
• 4:广州医学院第三附属医院药剂科 广州510150

摘要(Abstract)：

目的探讨肾移植受者服用环孢素A(CsA)后C0和C2血药浓度的监测的临床意义。方法采用荧光偏振免疫方法(FPIA)同时测定肾移植后两个月内接受CsA治疗患者的CsA谷值(C0)和峰值(C2)血药浓度。回顾性分析CsA的血药浓度监测方法在预测肾移植肝毒性和急性排斥的有效性。结果肾移植术后2个月内毒性反应(包括肝毒性和肾毒性)发生率54.1%(33/61);急性排斥发生率21.3%(13/61)。同步测定C0、C2各61次,毒性反应组与不发生毒性反应组的C0、C2平均值差异都有非常的显著性(P<0.01)。急性排斥与无排斥组的C0平均值差异无显著性(P>0.05);C2平均值差异有非常的显著性(P<0.01)。环孢素的C0能预测毒性反应的发生而不能预测急性排斥的发生;C2对毒性反应和急性排斥的发生都能起到预测的作用。结论肾移植术后患者以C2为监测点预防毒性反应、急性排斥反应和调整给药剂量比C0更具有科学性和敏感性。考虑C2的适宜浓度范围在900~1200μg.L-1。
Objective To explore the clinical significance of two-hour concentration(C_2) and the trough concentration(C_0) of CsA in renal transplant recipients.Method In the renal transplant recipients who were treated with CsA in two months after the operation,the blood concentrations were measured by fluorescence polarization immunoassay(FPIA).Result In two months after renal transplanting,the incidence side-effect was 54.1%(33/61),and the acute rejection rate was 21.3%(13/61).The 61 pairs of CsA C_0,C_2 monitoring showed that the difference was statistically significant between C_0 and C_2 levels of the recipients with side-effect and without side-effect.There was not statistically significant difference between C_0 levels of the recipients with rejection and non-rejection,but statistically significant difference was found between C_2 levels of the recipients with rejection and non-rejection.C_0 of CsA can forecast the side-effect but not the acute rejection,C_2 of CsA can forecast not only the side-effect but also the acute rejection.Conclusion For the renal transplant recipients,C_2 as a monitoring time point in preventing the side-effect and the acute rejection is more scientific and sensitive than C_0.The C_2 should be in a range of 900~1200 μg·L~(-1).

关键词(KeyWords)： 肾移植;环孢素A;血药浓度
renal transplantation;cyclosporine A;blood concentration

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 郑师明,司徒冰,谭湘萍,卢敏妍
ZHENG Shi-ming,SITU Bing,TAN Xiang-ping,LU Minyan(Dept.of Pharmacy

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