肾移植术后环孢素A血药浓度与肝毒性的关系

Correlation between the hepatotoxicity and the whole blood concentrations of cyclosporine A(CsA) after renal transplantation

目的研究肾移植术后用环孢素(CsA)为主的免疫抑制剂治疗的患者CsA血药浓度和CsA致肝毒性的关系。方法分别用单克隆荧光偏振免疫分析法测定肾移植术后患者环孢素全血浓度;同时,酶速率法、酶循环及比色法监测丙氨酸氨基转移酶(ALT)活力及血清总胆红素(TBiL)、总胆汁酸(TBA)等肝功能指标。结果术前肝功能正常的46例肾移植受者中,确诊有16人发生了环孢素致药物性肝功能损害。结论移植术后应用环孢素的患者应密切监测CsA的血药浓度,并结合临床肝功能指标,调整环孢素的用量,以避免或减轻肝中毒。

OBJECTIVE To investigate the correlation between the whole blood concentrations of cyclosporine A （Csa） an after renal d the occurrence of CsA induced hepatotoxicity in the patients on a CsA based immunosuppression regimen transplantation. METHODS Enzyme rate determination, enzyme circulation and colorimetric method were used to determine the activity of serum Alamine aminotransferase （ALT） and the content of total Bilirubin （TBiL）, total Bile Acid （TBA）in the patients and monoclonal fluorescence polarization immunoassay （FPIA）was used to analyze the whole blood CsA concentrations. RESULTS Of 46 recipients whose hepatic function was good before operation, 16 cases had suffered CsA induced liver lesion. CONCLUSION Monitoring of the whole blood concentration of cyclosporine and liver function indicator in individual patients in early phase after the operation may be helpful to making adjustment of his CsA usage so as to prevent effectively the arising of CsA-hepatotoxicity when CsA was used for treatment.