糖尿病肾病肾移植受者血环孢素浓度的监测指标

摘要目的探讨糖尿病肾病肾移植受者血环孢素（CsA）浓度的监测指标。方法采用酶增强免疫分析法监测17例糖尿病肾病肾移植受者全血中CsA的谷浓度（C0）和服药后2 h的峰浓度（C2），筛除出现肝、肾毒性或排斥反应的数据，并按手术后时间、性别和年龄分组进行统计分析。结果肾移植手术后第1 个月、第2～4 个月、第5～6个 月，C0＋C2的合理范围分别为800～1 800，700～1 500，600～1 200 ng•mL－1，C2/C0控制在4～8。结论用C0＋C2和C2/C0作为血CsA浓度的监测指标，更能反映糖尿病肾病肾移植受者体内CsA的暴露情况和肝肾功能，避免毒性和排异反应。

Monitoring Indicators for Plasma Cyclosporine A Concentration Assessment in Patients with Diabetis Nephropathy Receiving Renal Transplantation

Objective To study the optimal monitoring indicators for assessment of plasma cyclosporine A(CsA) in diabetic nephropathy(DN) patients receiving renal transplantation.Methods The lowest and highest concentration(C0,C2) of CsA in 17 DN patients receiving renal transplantation were detected by Enzyme-multiplied immunoassay technique(Emit).The data about liver toxicity,renal toxicity or rejection were eliminated and others were grouped and analyzed according to the time after-operation,gender and age.Results The rational range of(C0+C2) of CsA in the first month,second to fourth month,fifth to sixth month after renal transplantation were 800-1 800 ng·mL-1,700-1 500 ng·mL-1,600-1 200 ng·mL-1,respectively,while C2/C0 were within 4~8.Conclusion Using C0+C2 and C2/C0 as monitoring indicators for the plasma concentration of CsA,comprehensively reflects the drug exposure in body and toxicity of CsA to liver and kidney,and benefits for avoiding rejection and toxic effects.