肾移植受者环孢素A血药浓度变异系数的临床研究

目的研究环孢素A(CsA)血药浓度变异系数(CV)的临床意义.方法185例尸肾移植受者,其中口服CsA微乳剂(CsA-ME)组92例(排斥反应15例),口服CsA普通胶囊(CsA-GC)组93例(排斥反应21例).比较CsA-ME组与CsA-GC组CsA血药浓度变异系数的差异及排斥组与非排斥组CsA血药浓度变异系数的差异.结果CsA-ME组血药浓度变异系数小于CsA-GC组(P<0.05).排斥反应组CsA血药浓度变异系数高于非排斥组的变异系数(P<0.05).结论口服CsA-ME血药浓度更稳定.排斥反应的发生与CsA血药浓度不稳定有关.CsA血药浓度变异系数是反映个体对CsA生物利用度变化大小的较可靠的指标,可以指导临床血药浓度的监测频度.

Clinical study of coefficient of variation of cyclosporine blood concentration in renal transplant recipients

Objective To evaluate the clinical implication of coefficient of variation (CV) of cyclosporine (CsA) blood concentration.Methods Of the 185 recipients of cadaveric renal transplantation, 92 were treated with the microemulsion of CsA (CsA-ME) (15 cases occurring rejection), 93 with the emulsion get caps (CsA-GC) (21 occurring rejection). The CV of CsA blood concentration in the CsA-ME group was compared with that in the CsA-GC group and the CV of CsA in the rejection group with that in the non-rejection group.Results The CV of CsA blood concentration was lower in the CsA-ME group than in the CsA-GC group (P< 0.05), and the CV of CsA blood concentration was higher in the rejection group than in the non-rejection group (P<0.05).Conclusions The blood concentration of CsA-ME is more steady than that of CsA-GC. The episode of rejection is associated with the unsteady concentration of CsA. CV is a valuable index reflecting the individual variability in cyclosporine pharmacokinetics in renal transplant recipients and can be used to determine the frequency of blood monitoring.