肾移植患者内源性氢化可的松血药浓度监测的临床分析

目的:探讨肾功能稳定的肾移植患者内源性氢化可的松血药浓度监测的临床意义。方法:采用高效液相色谱法测定氢化可的松血药浓度,并对肾移植患者术后时间、性别、剂量与血药浓度间的关系进行分析。结果:患者的内源性氢化可的松血药浓度,术后1a内个体间有显著性差异(P<0.05);术后3mo,浓度趋于稳定,平均为(52.15±25.58)μg.L-1;强的松用药剂量及内源性氢化可的松血药浓度,在术后1a内,男、女组有显著性差异(P<0.05),1a后无显著性差异(P>0.05)。结论:内源性氢化可的松的血药浓度测定,可为临床合理使用糖皮质激素类药物提供参考。

Blood Concentration Monitoring of Endogenous Cortisol in Kidney- transplant Recipients: Clinical Analysis

OBJECTIVE: To explore the clinical value of blood concentration monitoring of endogenous cortisol in the kidney-transplant recipients with stable renal condition.METHODS: The blood concentration of cortisol was determined by HPLC and the correlations between blood concentration and the duration after renal transplantation,patients' sex and dose were analyzed.RESULTS: The blood concentration of endogenous cortisol showed significant individual difference within one-year transplantation time(P<0.05) and tended to be stable(mean value=(52.15± 25.58) μ g· L-1) at 3mo.Both the dose of prednisone and the blood concentration of endogenous cortisol showed significant differences(P<0.05) between female group and male group within one year after operation but no significant difference(P>0.05) after a year.CONCLUSION: The determination of blood concentration of endogenous cortisol provided reference for rational administration of glucocorticoid.