质子泵抑制剂对器官移植患者他克莫司血药浓度的影响

Effect of proton pump inhibitors on tacrolimus blood concentration in organ transplant recipients

他克莫司是大环内酯类免疫抑制剂,临床常用来抑制器官移植后的排斥反应,目前已成为移植术后一线用药。器官移植术后患者在使用他克莫司时通常需给予质子泵抑制剂,以预防胃肠道并发症,故两药合用患者占比较高。但他克莫司与质子泵抑制剂联用,往往导致他克莫司血药浓度波动。现有研究提示,这种波动可能与两种药物相互竞争CYP3A4代谢酶有关联。本文就他克莫司与质子泵抑制剂之间的相互作用进行综述,以期为临床应用提供参考。

Tacrolimus,a macrolide immunosuppressive agent,has been used as a first-line drug for the inhibition of rejection after organ transplantation.In general,the organ-transplanted patients need to administer proton pump inhibitors to prevent gastrointestinal syndrome when tacrolimus is used,and a high proportion of patients use the two drug combination.However,the combined use of tacrolimus with the proton pump inhibitor often gives rise to the fluctuation in the tacrolimus blood concentration.This fluctuation has been suggested to be likely related to the competition of the CYP3A4 metabolic enzyme between the two drugs.In this paper,the interaction between tacrolimus and different kinds of proton pump inhibitors is reviewed in order to provide reference for their clinical application.