99例肝移植患者的FK506血药浓度分析

Analysis of FK506 Blood Concentration in 99 Patients with Liver Transplantation

目的：探讨FK506（他克莫司）在肝移植患者血药浓度的控制情况及其出现不良反应的情况。方法：应用TAE法检测99例肝移植患者362例次FK506全血浓度，观察他克莫司理想的治疗窗并分析异常血药浓度形成的原因，为临床合理应用提供参考。结果：我院肝移植患者术后一个月内检测107例血样，FK506血药浓度为（8．6±3．0）ng·mL^-1，术后2—3个月血药浓度为（10．4±4．0）ng·mL^-1。以后血药浓度逐渐减低。与参考值相比，52.2％的患者血药浓度在参考值范围内，27．3％的患者血药浓度低于参考值，20．4％的患者血药浓度高于参考值。血药浓度的异常可能与合并用药及患者用药依从性有关，FK506不良反应的发生率相对少见，主要有感染、肾毒性和神经系统毒性等。结论：我院肝移植患者术后FK506血药浓度基本维持在推荐参考值范围低限，发生不良反应较少，可达到满意的免疫抑制治疗作用。

Objective： To analyze the blood concentration of FK506 in patients with liver transplantation, and investigate the adverse effect caused by FK506. Methods： A total of 362 cases from 99 patients with liver transplantation were determined by TAE. The ideal therapeutic window of FK506 and the reason of abnormal blood concentration were investigated. This might provide references for clinical rational use. Results： 107 cases were determined after the first month of liver transplantation, and the average concentration was （8.6 ± 3.0） ng·mL^-1. The average concentration was （ 10.4± 4.0） ng·mL^-1 after the second and third month of therapy. The sequent average concentration degraded gradually. Compared with the reference value, 52.2% concentration was within the reference value, 27.3% concentration under the reference value, 20.4% concentration above the reference value. The abnormal concentration might be caused by the combination use of drugs and the patients＇ compliance. In addition, adverse effects were rare, including infection, renal toxicity and nervous system toxicity, etc. Conclusion： The concentrations of FK506 in patients with liver transplantation are mostly consistent with the reference value. And the adverse effects are rare. As a result, FKS06 has satisfied immunosuppressive effect.