肾移植术后服用环孢素A2h血药浓度峰值监测及治疗窗浓度探讨

目的探讨肾移植术后国内患者服用环孢素A(CsA)2h血药浓度峰值在不同时期的监测范围。方法用荧光偏振免疫法(FPIA)同时测定92例肾移植受者CsA谷浓度(C0)和服药2h后峰浓度(C2),并观察排斥反应的发生及肝、肾毒性反应。结果肾移植术后CsA C2在不同时期监测范围建议0mo~1mo为1000~1300μg/L,2mo~3mo为950~1250μg/L,4mo~6mo为900~1100μg/L,7mo~12mo为750~1000μg/L,12mo以上为600~800μg/L。结论在上述治疗窗浓度范围,CsA既能达到满意的免疫抑制效果,又能减少排斥反应和肝、肾毒性的发生。

Monitoring of Peak Blood Concentration in Renal Transplant Recipients 2h after Oral Administration of Cyclosporine A and Study on Therapeutic Window Concentration

OBJECTIVE:To study the therapeutic window of peak blood concentration at different time in domestic renal transplant recipients2h after administration with cyclosporine A(CsA).METHODS:The valley bottom levels(C 0 )and the peak levels(C 2 )were determined simultaneously by fluorescence polarization immunoassay(FPIA)in92patients2h after oral administration with CsA,the rejection and the hepatic and renal drug toxicities were observed.RESULTS:The recommended therapeutic window concentration of CsA(C 2 )in Chinese renal transplant recipients was1000～1300μg/L within the first month,950～1250μg/L within the second to third month,900～1100μg/L within the fourth to sixth month,750～1000μg/L within the seventh to twelfth month,600～800μg/L from the twelfth month after renal transplantation.CONCLUSION:Within the above therapeutic window concentration range,CsA is of ideal immuno-suppressive action meanwhile it can less rejection and minimize the hepatic and renal drug toxicities.