FK506在肝移植术后的个体化治疗分析

Individualized treatment of FK506 after liver transplantation

目的探讨FK506(他克莫司)在肝移植术后的个体化治疗。方法回顾性分析了我院自2006年5月～2009年8月已经成功完成的119例肝移植,术后均以FK506为基础的抗免疫排斥用药的临床资料情况。结果无一例发生过严重的急性排斥反应,有9例发生过轻微的急性排斥反应,发生率为7.5%(9/119);9例患者全部治愈,其总的治愈率为100%(9/9);其中7例经过对FK506和MMF加量后治愈,治愈率为77.8%(7/9);2例逐渐加重最终接受激素冲击治疗而治愈,激素治疗的成功率为100%(2/2),激素治疗在整个治疗中占22.2%(2/9)。结论FK506在肝移植术后的抗免疫排斥用药应该遵循个体化的原则,从小剂量开始,应该结合患者的FK506的血药浓度、肝功能、机体耐受力等进行综合评估和调节。

【Objective】To investigate individualized treatment of FK506 （tacrolimus） after liver transplantation. 【Methods】The clinical data of 119 patients who underwent liver transplantation between May 2006 and August 2009 were studied retrospectively. These patients accepted individualized treatment of FK506 after liver transplantation; of which 98 patients underwent cadaver liver transplantation whereas 21 patients underwent living donor liver transplantation. There were 28 males and 91 females. 【Results】No one underwent severe acute rejection, except that 9 patients underwent slight acute rejection （7.5%） who were cured by active treatment with the cure rate of 100 % （9/9）. Of the 9 patients 7 were cured by adjustment of FK506 and MMF with the cure rate of 77.8 %; 2 worsened gradually through drugs dosage adjustment, but they were cured finally by hormone impact treatment with the success rate of hormone impact treatment of 100 % （2/2）.【Conclusion】It was important that patients accept individualized treatment of FK506 after liver transplantation. The individualized treatment should begin with small dosage and be regulated according to combined assessment of patient＇s FK506 blood concentration, liver function, body tolerance and so on.