肾移植受者血药浓度监测与最佳浓度选择

To monitor the therapeutic drug and choose the best concentration in renal transplant recipients

目的:寻找环孢素A(CsA)在肾移植受者三联免疫抑制用药方案中的最佳浓度。方法:用特异荧光偏振免疫法测定82例患者全血环孢素A的浓度,比较不同剂量组(各41例)患者肾移植术后CsA浓度高低、急性排斥反应和毒性反应发生率以及移植患者的人蛐肾生存率。结果:高浓度组在1年内总的急性排斥反应发生率为16.8%,低浓度组为18.2%,两组间差异无显著性(P>0.05),高低浓度组患者1年内毒性反应发生率分别为32.1%和16.4%(P<0.01),人蛐肾生存率分别为85.2%蛐82.8%和92.1%蛐90.9%(P<0.05)。结论:实验结果表明,低浓度组并不增加急性排斥反应的发生率,但明显降低毒性反应发生率以及移植患者的人蛐肾死亡率。

Objective:To establish the best concentration of CsA in renal transplant recipients on triple immunosuppressants regimen.Methods:The whole blood CsA of total 2072 samples from 82 cases renal transplant recipients were measured by fluorescence polarization immunoassay,and all patients were divided into high dosage group(n=41)and low dosage group(n=41).The occurrence rate of acute rejection,toxicity reaction and patient/graft survival rate were compared between the high and the low concentration group.Results:The occurrence rate of acute rejection were 16.8% and 18.2%(P>0.05),The toxicity reaction occurred rate was 32.1% and 16.4%(P<0.01),the patient/graft survival rate was 85.2%/82.8% and 92.1%/90.9%(P<0.05)between the high and the low concentration group in a year.Conclusion:The result indicates that the low concentration group does not increase the rate of acute rejection,but reduce the toxicity reaction occurrence rate and patient/graft death rate.