肝移植患者霉酚酸酯的应用与环孢素A监测

 目的探讨肝移植术后免疫抑制剂的应用及环孢素A血药浓度监测。方法特异性单克隆荧光偏振免疫法(mAFPIA)测定环孢素A血药浓度,肝移植术后免疫抑制方案：环孢素A+霉酚酸酯+泼尼松。结果霉酚酸酯与环孢素A对排异有协同作用，减少环孢素A的用量并减少环孢素A引起的肝、肾毒性；环孢素A的全血谷浓度在(160±30) ng·mL^-1可作为肝移植术后环孢素A剂量调整的依据。结论有霉酚酸酯的新三联免疫抑制方案对肝移植术后是安全、有效的，对临床治疗效果有重要意义。mAFPIA法对应用环孢素A患者的血药浓度监测简便、快速、稳定。

Clinical uses of mycophenelate mofetil and cyclosporin A in patients after liver transplantation

OBJECTIVE To investigate the use of immunosuppressants and to monitor the whole blood concentration of cyclosporine A(CsA)after liver transplantation. METHODS The concentrations of CsA in whole blood were measured by monoclonal fluorescence polarization immunoassay (mAFPIA).After liver transplantation,the immunosuppressive regimens were based on CsA combined with mycophenelate mofetil and prednisone. RESULTS Mycophenelate mofetil and CsA showed synergistic effects against rejection reaction.The incidences of nephrotoxic and hepatotoxic events were reduced after the dosage of CsA was decreased.The whole blood concentration of CsA within (160±30) ng·mL^-1 were suggested. CONCLUSION The triple immunosuppressive regimen after liver transplantation was safe and effective.mAPFIA method for the determination of whole blood concentration of CsA was simple,rapid,and stable.