糖尿病肾病肾移植受者术后血环孢素A浓度的特点分析

目的探讨糖尿病肾病肾移植受者术后血环孢素A(CsA)浓度的特点。方法采用酶增强免疫分析法(Emit),对34例(糖尿病肾病17例)肾移植受者全血中CsA的谷浓度(C0)和服药后2 h的峰浓度(C2)进行监测,筛除出现肝、肾毒性或排斥反应的数据,并按术后时间进行分组对比分析。结果糖尿病与非糖尿病肾病肾移植术后第1、2月CsA的C0值分别为(214±84)、(175±46)和(251±85)、(209±74)ng/ml,C2值分别为(1087±471)、(963±326)和(1570±600)、(1543±401)ng/ml,2组间差异有统计学意义(P<0.05)。其余月份2组间C0和C2差异无统计学意义(P>0.05)。结论糖尿病肾病肾移植受者术后1～2个月内C0和C2宜控制在(120～250)ng/ml和(550～1500)ng/ml范围内,并随术后时间的延长而逐渐下降,避免毒性和排异反应。

Concentration of plasma cyclosporine A in patients with diabetic nephropathy following renal transplantation

Objective To study the characteristics of plasma cyclosporine A （CsA） concentration in patients with diabetic nephropathy （DN） following renal transplantation. Methods The trough concentration （Co） and 2-hour concentration （C2） of CsA in 34 patients （17 with diabetic nephropathy and 17 without） following renal transplantation were monitored by using enzyme-multiplied immunoassay technique （Emit）. The data related to liver or renal toxicity or rejection were discarded, and comparisons were made based on the time after transplantation. Results Patients with DN and non-DN yielded a Co of （214±84）ng/ml and （175±46）ng/ml at month 1 and （251±85）ng/mL and （209±74） ng/ml at month 2 postoperatively, as well as a C2 of （1087±471）ng/ml and （963±326）ng/ml at month 1 and （1570±600） ng/ml and （1543±401）ng/ml at month 2 postoperatively （all P〈0.05）, respectively. The difference of Co and C2 in mis- cellaneous months of the year was unremarkable （P〉0.05）. Conclusion Patients with DN following renal transplan- tation are suggested to render the Co and C2 of CsA to be within （120-250）ng/ml and （550-1500）ng/ml at months 1 and 2, which should be further confined to a lower level thereafter. Toxicity and rejection should be avoided.