不同群体肾移植患者他克莫司临床应用初步探讨

目的:探讨肾移植患者应用他克莫司适用群体.方法:51名患者分为老年、成年肝炎病毒携带者和成年非肝炎病毒携带者.观察初始剂量他克莫司的血药浓度和术后3个月、1年他克莫司维持剂量变化及急、慢性排斥反应发生情况.结果:在相似的初始剂量下,老年和成年肝炎病毒携带者他克莫司血药浓度明显高于成年非携带者,而术后3个月及1年他克莫司维持剂量又明显低于成年非携带者.随着观察延迁,成年非肝炎携带者中发生2例急性排斥反应,1例慢性排斥反应,有3例因维持剂量一直偏高,难以承担昂贵药费,改用环孢素.结论:老年、成年肝炎病毒携带者术后应首选他克莫司,既减轻和避免药物副作用,药费相对无增高.

Clinical Application of Tacrolimus in Treating Patients of Renal Transplantation from Different Population

Objective: To study suitable population of renal transplantation patients in treating with tacrlimus. Method: 51 patients were divided into 3 groups; elder group, adult group with hepatitis virus (HV) and adult group without HV carrier. The tacroli-mus blood concentration of initial dosage, change of maintenance dosage of tacrolimus 3 months and a year after renal transplantation and acute or chronic rejection were observed. Result: Tacrolimus blood concentration of elder group or adult group with HV carrier were significantly higher than those of adult group without HV carrier with similar initial dosage, but maintenance dosage of elder group or a-dult group with HV carrier were markedly lower than those of adult group without HV carriers months or 1 year after renal transplantation. In the group of adult without HV, 2 patients suffered acute rejection. 1 patients suffered chronic injection, 3 patients could not bear the expensive medicine charge and had changed to use cyclosporine due to the over high maintenance dosage of tacrolimus. Conclusion: Tacrolimus may be the first choice for elder or adult group with HV carrier once after renal transplantation. Not only can side effects be decreased and avoided, but also expense will not increase relatively.