The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney t...The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney transplantation. The validation method was performed to the EMIT determination of CsA blood concentration, the CsA whole blood trough concentrations (Co) of patients in different time periods after renal transplantation were monitored, and combined with the clinical complications, the statistical results were analyzed and compared. EMIT was precise, accurate and stable, also with a high quality control. The mean postoperative blood concentration of CsA was as follows: 〈1 month, (281.4± 57.9)ng/mL; 2 - 3 months, (264.5 ± 41.2) ng/mL; 4 - 5 months, (236.4 ± 38.9) ng/mL; 6 - 12 months, (206.5± 32.6)ng/mL; 〉12 months, (185.6± 28.1)ng/mL. The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%, significantly lower than that of the none-recommended dose group (37.2%) (P〈0.05); the transplantation rejection rate was 4.4%, significantly lower than that of the none- recommended dose group (22.5%) (P〈0.05). Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible, and is able to reduce the CsA toxicity and rejection significantly, leading to achieving the desired therapeutic effect.展开更多
基金supported by the Project 973 Monitoring of the Immune Status and Rejection After Organ Transplantation"(2009CB522400)the National Natural Science Foundation of China(No.30972947)
文摘The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney transplantation. The validation method was performed to the EMIT determination of CsA blood concentration, the CsA whole blood trough concentrations (Co) of patients in different time periods after renal transplantation were monitored, and combined with the clinical complications, the statistical results were analyzed and compared. EMIT was precise, accurate and stable, also with a high quality control. The mean postoperative blood concentration of CsA was as follows: 〈1 month, (281.4± 57.9)ng/mL; 2 - 3 months, (264.5 ± 41.2) ng/mL; 4 - 5 months, (236.4 ± 38.9) ng/mL; 6 - 12 months, (206.5± 32.6)ng/mL; 〉12 months, (185.6± 28.1)ng/mL. The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%, significantly lower than that of the none-recommended dose group (37.2%) (P〈0.05); the transplantation rejection rate was 4.4%, significantly lower than that of the none- recommended dose group (22.5%) (P〈0.05). Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible, and is able to reduce the CsA toxicity and rejection significantly, leading to achieving the desired therapeutic effect.