酶放大免疫法监测159例肾移植患者他克莫司血浓度结果分析

Analysis of Blood Trough Concentration of Tacrolimus in 159 Renal Transplantation Patients Monitored by Enzyme Multiplied Immunoassay Technique

目的:探讨酶放大免疫法监测肾移植受者他克莫司谷浓度的情况及其对移植肾功能的影响。方法:回顾性分析酶放大免疫分析(EMIT)法监测159例肾移植受者术后2849例次他克莫司谷浓度的结果及肾移植术1个月后他克莫司谷浓度对血肌酐(Scr)的影响。结果:2 466例次(占总例次的86.5%)他克莫司谷浓度值处于参考值范围,低于下线及高于上线参考值的比例分别为6.3%、7.1%;肾移植术1个月后,当他克莫司谷浓度值小于5μg·L^(-1)或大于20μg·L^(-1)时,Scr值升高显著(P<0.05或0.01),当他克莫司谷浓度值小于5μg·L^(-1)或大于15μg·L^(-1)时,Scr异常值的比例显著增加。结论:用EMIT法监测他克莫司谷浓度值,药物浓度控制比较稳定,5～15μg·L^(-1)是相对安全的浓度范围。

Objective： To investigate the blood trough concentration and the effects on renal function of tacrolimus in 159 renal transplantation patients by enzyme multiplied immunoassay technique （EMIT）. Method： 2 849 trough concentrations Of taerolimus （Tac） from 159 patients accepted kidney transplantation were determined by EMIT. The trough concentrations of tacrolimus at different times after the renal transplantation and the effect on serum creatinine （Scr） one month after the transplantation were investigated. Re- sult： 86. 5% （2 466/2 849） trough concentrations of Tae were within the reference value,while 6. 3% under the reference value and 7.1% above the reference value. One month after the renal transplantation with the trough concentration of Tac lower than 5μg·L^-1 and higher than 20 μg·L^-1, the Scr was significantly increased （ P 〈 0. 05, P 〈 0. 01 ）. When the trough concentration of Tae was lower than 5 μg·L^-1 and higher than 15μg·L^-1, the rate of Scr abnormal value was raised. Conclusion： The concentrations of Tac in patients with renal transplantation are mostly consistent with the reference value monitored by EMIT. The trough concentration of Tac within the range of 5-15 μg·L^-1 may be relatively safe to the renal function.