肾移植术后患者他克莫司血药浓度的影响因素：CYP3A5基因多态性

The Factor on the Plasma Concentration of Tacrolimus in the Early Period Post-renal Transplantation： CYP3A5 Polymorphisms

目的探讨肾移植术后CYP3A5基因多态性对他克莫司血药浓度的影响。方法分析中国人民解放军181医院全军器官移植与透析中心于2012年11月至2013年11月行同种异体肾移植术符合条件的63例患者的资料，采用随机数字表法分为实验组和对照组，比较两组患者的CYP3A5＊3基因型，住院期间服用他克莫司剂量、血药浓度、调整剂量的次数、急性排斥反应及不良反应等情况。结果两组术后第7天达到目标浓度的比例及需要调整剂量受者比例，实验组急性排斥反应和他克莫司不良反应发生率均低于对照组，差异有统计学意义（P〈0．05）。结论根据CYP3A5基因型的不同，建立他克莫司个性化给药方案，他克莫司的血药浓度稳定，能降低移植’肾的急性排斥反应及不良反应。

ObjectiveTo explore the effects of CYP3A5 polymorphisms on the plasma concentration of Tacrolimusspansule in the early period post-renal transplantation. MethodsFrom November 2012 to November 2013 , the clinical data of 63 cases of renal transplantation were retrospectively analyzed in the 181 st Hospital of PLA. The 63 cases were randomly divided into the experimental group and the control group. The intake of tacrolimus dose, plasma concentration,the incidence of adverse reactions and acute rejection （AR） between two groups were compared. ResultsThe ratio to reach the target concentration in postoperative 7 days was 78.1%（25/32） in the experimental group ,38.7%（12/31） inthe control group.The incidence of AR was 6.3 % （2/32） in the experimental group , and 22.6（7/31） in the control group. The statistical difference is significant（ P 〈0.05 ）. ConclusionsBased on the CYP3A5 genotype, establishing personalized tacrolimus dosing regimen, can keep plasma concentrations of tacrolimus stable, and reduce The incidence of acute rejection and adverse reactionsin the early period post-renal transplantation.