肾移植术后监测CsA谷浓度的临床价值

CLINICAL SIGNIFICANCE OF MONITORING CSA TROUGH LEVEL AFTER RENAL TRANS PLANTATION

为了探讨ＣｓＡ谷浓度（ＴＬ）与临床急性排异和中毒的关系，我们对我院１９９０年５月至１０月４６例肾移植病人（男３８例、女８例）术后１０９次系列ＣｓＡ－ＴＬ进行了分析。结果：肾移植术后系列测定全血ＣｓＡＴＬ对急性排异和ＣｓＡ中毒的诊断有帮助。三联疗法（Ｐｒｅｄ＋ＣｓＡ＋Ａｚａ）与二联疗法（Ｐｒｅｄ＋Ａｚａ）的治疗窗不同。术后３月内，二联疗法合适的治疗窗是２００－４００ｎｇ／ｍｌ，当ＣｓＡ－ＴＬ ２００ｎｇ／ｍｌ，７８．２６／病人出现急性排异，而当ＣｘＡ－ＴＬ＞４００ｎｇ／ｍｌ，则３３．３％与ＣｓＡ肾中毒相联系。二联疗法合适的治疗窗是２５０－５００ｎｇ／ｍｌ，当ＣｓＡ－Ｔｌ ２５０ｎｇ／ｍｌ．６４％出现急性排异，ＴＬ＞５００ｎｇ／ｍｌ，急性ＣｓＡ肾中毒发生率４０％。当ＣｓＡ－ＴＬ＞６００ｎｇ／ｍｌ，三联与二联疗法的感染率分别是３３．３３％和３８．０９％。

AbstractPost-transplantation CsA-TL was analysed in 46cases with 109 samples. The results showed a series ofdetermination of CsA-TL after transplantation gave ahelp to the diagnosis of CsA poisoning and acute rejec-tion. A different treatment range between triple andbigemany therapy was found. We suggested monitor-ing CsA-LT after renal transplantation was useful andimportant .