【摘要】 目的探讨肾移植受者服用环孢素A(CsA)后C0和C2血药浓度的监测的临床意义。方法采用荧光偏振免疫方法(FPIA)同时测定肾移植后两个月内接受CsA治疗患者的CsA谷值(C0)和峰值(C2)血药浓度。回顾性分析CsA的血药浓度监测方法在预测肾移植肝毒性和急性排斥的有效性。结果肾移植术后2个月内毒性反应(包括肝毒性和肾毒性)发生率54.1%(33/61);急性排斥发生率21.3%(13/61)。同步测定C0、C2各61次,毒性反应组与不发生毒性反应组的C0、C2平均值差异都有非常的显著性(P<0.01)。急性排斥与无排斥组的C0平均值差异无显著性(P>0.05);C2平均值差异有非常的显著性(P<0.01)。环孢素的C0能预测毒性反应的发生而不能预测急性排斥的发生;C2对毒性反应和急性排斥的发生都能起到预测的作用。结论肾移植术后患者以C2为监测点预防毒性反应、急性排斥反应和调整给药剂量比C0更具有科学性和敏感性。考虑C2的适宜浓度范围在900~1200μg.L-1。更多还原

【Abstract】 Objective To explore the clinical significance of two-hour concentration（C₂） and the trough concentration（C₀） of CsA in renal transplant recipients.Method In the renal transplant recipients who were treated with CsA in two months after the operation,the blood concentrations were measured by fluorescence polarization immunoassay（FPIA）.Result In two months after renal transplanting,the incidence side-effect was 54.1%（33/61）,and the acute rejection rate was 21.3%（13/61）.The 61 pairs of CsA C₀,C₂ monitoring showed that the difference was statistically significant between C₀ and C₂ levels of the recipients with side-effect and without side-effect.There was not statistically significant difference between C₀ levels of the recipients with rejection and non-rejection,but statistically significant difference was found between C₂ levels of the recipients with rejection and non-rejection.C₀ of CsA can forecast the side-effect but not the acute rejection,C₂ of CsA can forecast not only the side-effect but also the acute rejection.Conclusion For the renal transplant recipients,C₂ as a monitoring time point in preventing the side-effect and the acute rejection is more scientific and sensitive than C₀.The C₂ should be in a range of 900¹200 μg·L^-1.更多还原