环孢素A对肾移植患者血清肝酶活性及总胆汁酸水平的影响

The influence of cyclosporine A on the activity of serum hepatic enzymes and the content of total bile acid in patients with renal transplantation

目的 :监测肾移植患者血清肝酶谷丙转氨酶 (ALT)、谷草转氨酶 (AST)、谷氨酰转肽酶 (r -GT)、碱性磷酸酶 (ALP)活性及总胆汁酸 (TBA)、总胆红素 (TBIL)水平的变化 ,了解环孢素A (CSA)的肝毒性作用。方法 :采用酶速率法、酶循环法及比色法 ,对 58例肾移植术后患者血清肝酶活性及总胆汁酸、总胆红素水平进行监测。结果 :移植术后早期 1～ 3个月内及半年左右 ,发生肝酶活性及总胆汁酸升高异常比例较高。结论 :药物的肝毒性在肾移植中应引起足够的重视 ,应及时监测肝酶活性及TBA水平 。

Objective:To monitor the changes of the activity of ser um hepatic enzymes(ALT,AST,γ-GT and ALP)and the content of total bile acid(TBA) and total bilirubin(TBIl)to explore the hepatotoxicity of cyclosporine A(CsA). Methods:Enzyme rate determination,enzyme circulation method and co l orimetric method were used to determine the activity of serum hepatic enzymes an d the content of TBA and TBIL in 58 patients after renal transplantation. Results:During 1 to 3 months,even half a year after transplantation,th e incidence rate of abnormal increase in the activity of serum hepatic enzymes an d TBA was comparatively high.Conclusion:Much attention should be paid on the hepatotoxicity of drugs in renal transplantation.Monitoring of the activity of serum hepatic enzymes and content of TBA must be good for the adjust ment of immunodepressant dosage and the hepatic protection measures.