硝苯地平对肾移植术后患者血中环孢素A浓度的影响

Effect of Nifedipine on blood concentration of cyclosprine A after renal transplantation

目的 :观察硝苯地平 (商品名 :拜新同Nifedipine)对肾移植术后患者血中环孢素A浓度的影响。方法 :把服用环孢素A (商品名 :赛斯平CycloprineA ,CSA)的肾移植术后的患者分为服用硝苯地平 (A组 )和未服用硝苯地平 (B组 )两组 ,应用荧光偏振免疫测定法监测他们血中CSA的药物浓度。结果 :术后 1个月时两组服用CSA的量为A组 :6 45± 0 78mg/kg·d- 1 ;B组 :6 78± 0 83mg/kg·d- 1 。CSA浓度分别为A组 :478 4± 58 2ng/ml;B组 :32 4 7± 68 5ng/ml。 1 2个月时两组服用CSA的量为A组 :2 44± 0 2 7mg/kg/d ;B组 :3 0 6± 0 55mg/kg·d- 1 。CSA的浓度为A组 :1 96 7± 41 5ng/ml;B组 :1 84 8± 46 6ng/ml。两组有显著性差异 (P <0 0 1 )。结论 :硝苯地平对肾移植术后患者血中CSA浓度有很大的影响 ,它可以导致CSA的清除率降低 ,从而大大地提高了CSA的血药浓度。因此临床上应增加CSA浓度的检测次数 。

Objective:To observe the effects of Nifedipine on blood concentration of cyclosprine A after renal transplantation.Methods:All patients were divided into two groups randomly and respectively:A group (given Nifedipine);B group(Not given Nifedipine).To monitor blood concentration of cyclosprine A was performed using the fluorescence polarization immunoassay.Results:For lst month,cyclosprine A dosage are:A group,6 45±0 78mg/kg·d -1 ;B group,6 78±0 83mg/kg·d -1 .While blood concentration of cyclosprine A are:A group,478 4±58 2ng/ml;B group,324 7±68 5ng/ml.For 12 month,cyclosprine A dosage:A group,2 44±0 27mg/kg·d -1 ;B group,3 06±0 55mg/kg·d -1 .Meanwhile,Blood concentration of cyclosprine A:A group,196.7±41 5ng/ml;B group,184 8±46 6ng/ml.There was a significant difference( P <0 01).Conclusions:Nifedipine remarkably influences the concentration of cyclosprine A after renal transplantation,which widely increases blood concentration of cyclosprine A by effect of decreased cyclosprine A clearance rate.As a ersult,its neccessary for us to increase measure times for blood concentration of cyclosprine A to avoid of toxicosis of cyclosprine A.