肾移植受者FK506治疗窗浓度的临床观察

目的：寻求适合国人肾移植受者ＦＫ５０６理想治疗窗浓度范围。方法：应用ＥＬＩＡ法测定口服ＦＫ５０６ １２ｈ后全血谷浓度。结果：统计资料显示,术后第１个月应为１２～１８μｇ／Ｌ,第２～３个月为８～１３μｇ／Ｌ;第４个月后为５～８μｇ／Ｌ。结论：此浓度范围既能达到满意的免疫抑制效果,又有减少排斥反应和ＦＫ５０６肾毒性。

CLINICAL INVESTIGATION ON THE THERAPEUTIC WINDOW CONCENTRATION OF FK506 IN RENAL ALLO-GRAFF RFIPIENTS

OBJECTTVE To find a reference therapeutic window concentration of FK506 in antirejection regime for Chinese renal allograft recipients. METHODOLOGY Between Mar 1998 and May 1999,28 cases of renal recipients (male/female 23/5)administered FK506 in the antirejection regime. Regular sampling of early morning blood was collected in the first 3 months aftertransplantation for the determination of FK506 concentration. After the 3rd month, irregular sampling for FK506 whole blood concentration was perrormed. Trough level of FK506 was assayed with MEIA. Serum creatirine, urine volume,renal graft ultrasound image were also monitored regularly. RESULTS The whole blood FK506 trough level was 12 ～ 18 μg/L within the first month,8～ 12μg/L within the second and third month,5 ~ 8μg/L after the 4th month after transplantation. One in 28 patients developed acute renal graft rejection at a trough FK506 concentration at 4.30μg/L 41 days after transplantation. Another two patients developed acute nephrotoxicity within one month after transplantation with FY506 whole blood concentration above 20μg/L. CONCLUSION A reference window eoncentration of FK506 for antirejection in renal allograft recipients is established, with thetrough concentration at 15.4 ± 2.30 μg/L in the first month, 10.3±1.80μg/L between the 2nd and the 3rd month, and 6.70 ±0.90μg/L after the 3rd month of renal transplantation.