肾移植术后应用FK506的神经毒性作用

目的 观察肾移植患者术后应用ＦＫ５０６（普乐可复）的脑中枢神经系统症状。方法对７１例肾移植患者术后应用 ＦＫ５０６的血药浓度及神经系统症状和体征进行动态观察。结果对例患者中有１１例出现中枢神经系统异常，其中３例 出现严重神经系统并发症，此３例中１例脑电图及脑ＣＴ出现轻度异常。多数患者症状可自行消失，部分患者调低药物 浓度后可在短期内渐缓解，但严重者需停药较长时间后才可好转。结论ＦＫ５０６是一种高效抗排斥药物，多数患者用药 后精神神经症状缓和，神经系统体检及影像学检查无明显改变或仅有轻微异常改变，但少数患者即使在治疗剂量下亦 可产生严重的中枢神经系统并发症。

Central nervous system toxicity induced by tacrolimus after renal transplantation

Objective To observe the centre1 nervous system symptoms in renal transplantation recipients receiving postoperative immunosuppressant tacrolimus (FK506). Methods The neurological symptoms resulting from FK506 administration after renal transplant in 71 recipients were observed and serum FK506 levels determined. Results During the immunosuppressive therapy with FK506, neurological symptoms of the central nervous system were observed in 11 patients, 3 of whom were in serious condition. One patient of the 3 with severe central neurological complications showed slight abnormalities in ECG and CT scan, while the other 2 did not. The symptoms of the majority of patients were self-limited and relieved without medical intervention, and in some cases, reduction of the dosage of FK506 was necessitated. In the most serious case, even complete withdrawal of medication failed to improve the symptoms in a short period of time. Conclusions FK506 is a potent immunosuppressant that may cause neurological complications, though mild in most cases. It should be noted that, however, normally therapeutic doses of FK506 might result in serious central nervous system symptoms in some cases, without or with only slight abnormal findings in physical, electrocardiographic or CT examination.