CsA肾中毒时血桨中6-酮-PGF_(1α)和TxB_2的变化

CLINICAL STUDY ON PLASMA 6- Keto-PGF_(1a) AND TxB_2 CHANGES IN CsA NEPHRO-INTOXICATION

本试验检测了21例肾移植病人血浆中6-酮-PGF_1α和TxB_2的浓度。结果表明,当临床出现CsA肾中毒症状前1～3天和当日,血浆中6—酮—PGF_1α水平明显降低。从而分析CsA肾中毒的发生可能是由于PGI_2降低后,使血浆中TxA_2和PGI_2的比例发生变化,TxA_2相应增加,在肾血管中微小血栓形成,使肾小球滤过率降低出现肾中毒的临床症状。我们认为在器官移植后应用CsA的病人中进行PGI_2的监测可以在临床早期发现CsA肾中毒,成为CsA肾中毒的可靠监测指标之一。

To study the mechanism of CsA-induced nephro-intoxication and find an effective monitory method for early detection, we measured plasma level of 6-keto-PGF1a and TxB2 (a main metabolite of PGI2 and TxA2 ) , using radio-immunoassay (RIA) in 21 kidney transplantation patients for 30 days.All these patients were treated with CsA and prednisone.Nine cases of CsA nephro-intox-ication occurred.One to three days prior to CsA nephro-intoxication, plasma level of 6-keto-PGF1a was decreased markedly (P<0. 05) . These results suggest that specific inhibition of PGI2 may be one of the causes inducing CsA nephro-intoxication,and measuring plasma PGI2 level in transplantation Patients may be an effective monitory method for recognition of CsA nephro-intoxication.