摘要
目的:考察肾移植(RT)术后不同时期环孢素A(CsA)谷浓度与肾移植效果的关系。方法:采用荧光偏振免疫(FPIA)法,对126例次RT术后0个月~24个月的患者进行常规CsA谷浓度监测,并结合患者临床症状进行归纳、分析、统计。结果:RT术后早期出现中毒反应的浓度为(698.32±61.83)ng·ml-1,为有效治疗浓度最高值的1.55倍,而后期出现中毒反应的浓度为(363.08±73.66)ng·ml-1,为有效治疗浓度最高值的2.42倍;术后早、后期排异反应发生率及中、后期毒性反应的发生率均有显著性差异(P<0.05)。结论:长期服用CsA后患者对中毒的耐受性增加;RT术后早期排异反应发生率较后期明显,而早、后期的中毒反应发生率均较中期明显升高。由于个体差异较大,在RT术后各个时期都应加强血药浓度的监测,早期以预防排异为主,后期则以预防中毒为主。
Abstract
OBJECTIVE: To investigate the relationship between the minimum concentration (cmin) of Cyclosporine A(CsA) and the results of renal transplant (RT). METHOD: The cmin of CsA of 126 RT cases was monitored by using the method of fluorescence polarization immunoassay (FPIA) within 0 months ~24 months after operation. The results were statistically analyzed in conjunction with the symptoms of the patients. RESULTS: The average CsA concentration was (698.32±61.83) ng·ml-1 for those who had poisoning reaction in early postoperation stage (POS). Which was 1.55 times of the upper limit of the therapeutic concentration range, while the concentration was (363.08±73.66) ng·ml-1 for those who had poisoning reaction in late POS, which was 2.42 times of the upper limit. Significant differences were found at the rate of exclusive reaction between the early and late POSs, and also at the rate of poisoning reaction between the middle and late POSs (P<0.05). CONCLUTIONS: The tolerance effect of the patients on poisoning reaction rises after using CsA for a long time. The rate of exclusive reaction is much higher in early POS than in late POS, while the rate of poisoning reaction is much higher in the early and late POSs than in middle POS. In view of the remarkable differences between individuals, it is necessary to monitor the CsA concentration in all POSs. Attention should be focused on preventing exclusive reaction in early POS while on preventing poisoning reaction in late POS.
关键词
环孢素A /
谷浓度 /
中毒反应 /
排异反应
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Key words
Cyclosporine A /
minimum concentration /
poisoning reaction /
exclusive reaction
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石杰;于宝东;初晓;王少华;闫美兴.
环孢素A谷浓度与肾移植术后效果之回顾性分析[J]. 中国药学杂志, 1998, 33(05): 297-299
Shi Jie.
The relationship between the minimum concentration of Cyclosporine A and the results of renal transplant [J]. Chinese Pharmaceutical Journal, 1998, 33(05): 297-299
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参考文献
1 徐向阳.环孢素A的研究进展及其在肾移植中的应用.医学临床与研究,1993,2(3):49.
2 Newburger J,Kahan BD.Cyclosporine pharmacokineties in man.Transplant proc,1983,15(8):2413.
3 Wilms HWF,Straeten V,Lison AE.Different Pharmacokinetice of cyclosporine A early and late after renal transplantation.Transplant Proc,1988,20(2):481.
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脚注
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