双环醇治疗肾移植术后肝损伤的应用

Application of bicyclol in patients with hepatic lesion after kidney transplantation

目的:研究双环醇治疗肾移植术后环孢素致肝损伤的疗效。方法:12例因环孢素致肝损伤的肾移植术后患者每日口服双环醇75mg,持续给药2周。口服双环醇前后患者自肘静脉采血,在自动生化分析仪上测定肝功能,并以特异性荧光偏振免疫法测定环孢素全血药物浓度。结果:全部12例肾移植术后患者在口服双环醇(75mg)2周后,血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)均显著下降(P<0.01),ALT水平从(126.8±99.3)U/L显著降至(31.5±12.4)U/L(P<0.01),AST水平从(67.4±55.5)U/L显著降至(29.6±14.9)U/L;同时环孢素血药浓度明显降低(P<0.05),从(243.72±67.22)ng/mL减少至(157.71±54.73)ng/mL。12例患者中没有观察到药物不良反应。结论:双环醇能有效且比较安全地应用于肾移植术后环孢素致肝损伤患者,但环孢素血药浓度有改变,应注意临床监测。

Objective:The efficacy of bicyclol in patients with hepatic lesion induced by cyclosporine after kidney transplantation was investigated.Methods: 12 renal transplanted recipients with eyclnsporine induced hepatic lesion were given bicyelol 75mg per day for 2 weeks. Before and after the bicyclol treatment,venous blood was collected from antecubital vein.Hepatic function was determined on a biochem auto-an-alyzer and eyclosporine whole blood concentrations were measured by a fluorescence polarization immunoassay.Results: After the bicyelol treatment of 2 weeks,ALT and AST levels were decreased significantly (P<0.01),with ALT from(126.8±99.3)U/L to(31.5±12.4)U/L and AST from (67.4±55.5)U/L to (29.6±14.9) U/L,respectively. While the cyclosporine whole blood concentrations were decreased too(P<0.05),from(243.72±67.22)ng/mL to (157.71±54.73)ng/mL.No severe adverse drug reaction was observed in 12 renal transplanted recipients.Conclusions:The results indicated that bicyclol would be applied to with hepatic lesion induced by cyclosporine after renal transplantation effectively and safely. Therapeutic drug monitoring should be paid attention on the patients due to the change of cyclospofine level.