【摘要】 目的探讨CYP3A5基因多态性对肾移植术后他克莫司血药浓度/剂量比值的影响。方法选取2011年1月至2016年3月间,在中国医科大学附属第一医院接受初次肾移植的66例受者为研究对象。检测肾移植受者CYP3A5基因多态性,观察不同基因型对他克莫司浓度/剂量比及预后的影响。结果 CYP3A5*3/*3组术后浓度/剂量比均明显高于其他两组(P<0.05)。术后1个月共6例患者发生急性排斥反应,4例为CYP3A5*1携带者。结论 CYP3A5基因多态性与肾移植受者术后他克莫司浓度/剂量比相关。携带CYP3A5*1基因者需要更高剂量他克莫司以维持足够的血药浓度,移植早期可能因免疫抑制不足发生排斥反应。更多还原

【Abstract】 Objective To determine the influence of CYP3A5 genetic polymorphisms on tacrolimus pharmacogenetics in Chinese renal transplant recipients. Method Sixty-six renal recipients treated with tacrolimus were genotyped for CYP3A5(6986A>G) single nucleotide polymorphisms. Genotypes were correlated to tacrolimus daily dose and concentration/dose ratio post-transplantation and with incidence of acute rejection. Result The concentration/dose ratios of CYP3A5*3 homozygotes were significant higher compared to CYP3A5*1 carriers(P<0.05). At 1 months after operation, 6 patients had acute rejection and 4 were CYP3A5*1 carriers. Conclusion CYP3A5 genetic polymorphism is associated with concentration/dose ratio. Patients with CYP3A5*1/*1 genotypes need higher doses of tacrolimus to achieve target concentration and may have risk of acute rejection at early phase due to under immunosuppression. Screening for this polymorphism could be helpful to choose the suitable calcineurin inhibitors or determine the suitable initial dose.更多还原