肝移植受者他克莫司治疗窗浓度的初步探讨

目的探讨肝移植受者他克莫司治疗窗浓度参考范围。方法采用化学发光微粒子免疫法(CMIA)监测他克莫司全血谷浓度(C0),结合受者的临床表现及生化指标,对74例肝移植受者的305例次监测结果进行分析。结果肝移植术后前3个月他克莫司C0为(7.0±3.6)ng/ml,3个月后为(5.5±2.3)ng/ml。术后发生急性排斥反应4例次,肝、肾毒性54例次。结论建议将实验室他克莫司治疗窗范围进行调整:肝移植术后前3个月为7～15ng/ml,3个月后为5～10ng/ml,以保证免疫抑制效果,减少排斥反应和肝、肾毒性。

Preliminary research of the therapeutic window concentration of tacrolimus in liver transplant recipients

Objective To investigate the therapeutic window concentration of Tacrolimus in liver transplant recipients.Methods 305 whole blood trough concentration of Tacrolimus in 74 liver transplant recipients were determined by chemiluminescent microparticle immunoassay(CMIA) combined with the clinial presentations and biochemical indexes of recipients.Results The whole blood trough concentration of tacrolimus was(7.0±3.6) ng/ml within the first 3 months,and it was(5.5±2.3) ng/ml 3 months after transplantation.There were 4 case-times of acute rejection and 54 case-times of liver and kidney toxicity.Conclusion The blood trough level of Tacrolimus should be adjusted as follows:7～15 ng/ml within the first 3 months,5～10ng/ml from the third month after transplantation.This range of therapeutic window concentration was ideal for liver transplant recipients with less acute rejection and toxicity effects.