特异性荧光偏振免疫法监测521例肾移植后环孢素A全血浓度3275次

Monitoring of whole blood level of cyclosporinein 3275 samples from 521 renal transplant recipientsby specific fluorescence polarization immunoassay

目的通过监测肾移植后病人环孢素A(CsA)全血浓度 ,提出CsA在三联免疫抑制用药方案中的理想治疗窗。方法用特异性荧光偏振免疫法测定CsA全血浓度 ,对521例病人监测3275次 ,按术后时间及临床表现分组比较。结果肾移植后<1 ,、1～3、3～6、6～12个月、1～2和>2年的CsA全血谷浓度的理想治疗窗应分别为250～450、200～400、150～300、100～250、100～200和100～180μg/L。结论CsA全血浓度在上述范围内 。

Aim To monitor the whole blood trough concentration of cyclosporine A(CsA) in renal transplant recipients, and to suggest optimal therapeutic window of CsA. Methods CsA concentration in 3275 blood samples from 521 renal transplant recipients was measured by specific fluorescence polarization immunoassay. The whole blood trough CsA concentrations were compared according to different times after operation and clinical symptoms. ResultsThe optimal therapeutic window of CsA should be 250～450 μg/L (less than 1 month after operation), 200～400μg/L(1～3 months), 150～300μg/L (3～6 months), 100～250μg/L(6～12 months), 100～200μg/L(1～2 years), 100～180μg/L(more than 2 years), 100～180μg/L(more than 2 years), respectivily. Conclusion The satistical analysis indicated that frequency of toxic effects and rejection reaction would significantly be reduced if CsA whole blood levels were adjusted to therapeutic and safe range.