肾移植术后稳定期患者CsA剂量/浓度个体差异研究

Study on the differences of cyclosporin,s dosage and concentration between individuals in stable phases after renal transplantation

目的探讨肾移植术后稳定期患者环孢素A(CsA)剂量/浓度个体差异的原因。方法选择117例口服新山地明(CsA)、霉酚酸酯和泼尼松三联免疫抑制抗排斥的肾移植术后稳定期患者,记录其临床和实验室指标,后行多元线性回归分析。结果9个自变量对因变量的影响从大到小依次为多药耐药基因1(MDR1)3435(1)、MDR11236(1)、细胞色素酶P450-3A5(CYP3A5)(2)、低密度脂蛋白胆固醇(LDL)、直接胆红素(DBIL)、年龄、总胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL)、淋巴细胞(L);对方程内各自变量单独检验,CYP3A5(2)、MDR1 3435(1)、MDR1 1236(1)、DBIL、年龄、LDL、HDL对因变量有显著影响。结论影响肾移植术后稳定期患者CsA剂量/浓度的主要因素有CYP3A5、MDR1 3435、MDR1 1236、DBIL、年龄、血脂。

Objective To study the influential factors responsible for the differences of cyclosporin, s dosage and concentration between individuals in stable phases after renal transplantation. Methods The clinical data consisted of 117 receptors more than one year after renal transplantation, whose immune suppressions were cyclosporin, mycophenolate and prednisone. All the receptors＇ related index of clinical and lab were recorded, and multiple linear regression was used for statistical analysis. Results The influences of independent variables on dependent variables in order of size were MDR1 3435（1）〉MDR1 1236（1） 〉 CYP3A5（2） 〉 LDL 〉 DBIL 〉 Age 〉 TC 〉 HDL 〉 L. In the solitude analysis, MDR1 3435（1）, MDR1 1236（1）, CYP3A5（2） , DBIL, Age, LDL and HDL showed statistical differences. Conclusion The main factors affecting cyclosporin, s dosage and concentration differences between individuals are MDR1 3435, MDR1 1236, CYP3A5, DBIL, Age and blood fat, and their influences decrease in order.