CYP3A5*3基因多态性与肾移植患者围手术期他克莫司相关不良反应的关系

目的：明确细胞色素P450（Cytochrome P450，CYP）3A5*3基因多态性与肾移植患者围手术期他克莫司相关不良反应的关系。方法：选取2014年11月至2018年3月于某院行肾移植术且术后应用他克莫司的患者170例，检测其CYP3A5*3基因型，记录患者肾移植术后入院期间的用药情况、各项临床指标及他克莫司相关不良反应的发生情况。比较不同CYP3A5*3基因型患者间他克莫司相关不良反应发生率。结果：CYP3A5*1是肾移植患者发生他克莫司相关移植后高脂血症的保护因子，CYP3A5表达型患者发生移植后高脂血症的风险仅为非表达者的0.465倍（95% CI：0.217~0.996，P=0.049）。结论：CYP3A5*3基因多态性与肾移植患者发生他克莫司相关移植后高脂血症的风险显著相关，其机制可能与与CYP3A5非表达型患者对他克莫司的代谢能力较低，使其在体内积蓄有关。

The relationship between CYP3A5*3 gene polymorphism and tacrolimus-related adverse reactions in renal transplant patients during perioperative period

OBJECTIVE To clarify the relationship between cytochrome P450(CYP) 3A53 gene polymorphism and perioperative tacrolimus-related adverse reactions in renal transplant patients during perioperative period.METHODS 170 patients who underwent renal transplantation from November 2014 to March 2018 in a hospital and received tacrolimus after operation were selected and their CYP3A53 genotypes were detected The medication status, various clinical parameters and occurrence of tacrolimus-related adverse reactions during admission after renal transplantation were recorded.. The incidence of tacrolimus-related adverse reactions was compared among patients with different CYP3A5*3 genotypes.RESULTS CYP3A5*1 was a protective factor for tacrolimus-related hyperlipidemia after transplantation in renal transplant patients. Patients who expressed CYP3A5 had a 0.465 times risk of posttransplant hyperlipidemia as patients who didn’t express CYP3A5(95%CI: 0.217-0.996, P=0.049).CONCLUSION CYP3A5*3 gene polymorphism was significantly associated with the risk of tacrolimus-related hyperlipidemia in renal transplant patients during the perioperative period. The mechanism may be related to a low metabolic capacity for tacrolimus in CYP3A5 non-expressing patients, which results in tacrolimus accumulation in the body.