肾移植患者他克莫司血药浓度监测结果分析.docVIP

肾移植患者他克莫司血药浓度监测结果分析 王春燕 徐霞 纪松岗 李明春（中国人民解放军第401医院药剂科，青岛市 266071） [摘 要] 目的肾移植术后）浓度，观察并建立患者理想治疗窗，为临床提供参考。方法用ELISA法测定全血谷浓度，对74肾移植术后患者共1824例次测结果进行分析。结全血谷浓度平均值随移植后时间的延长而逐渐下降术后1个月内4.9215.54μg·L－1，1-3个月5.2911.15μg·L－1，3-6个月4.0910.37μg·L－16-12个月3.678.77μg·L－1，12-24个月3.318.67μg·L－1 ，2年-5年2.708.06μg·L－1 ，大于5年维持在2.357.78μg·L－1。结论FK506吸收个体差异大，建议肾移植患者FK506治疗窗范围为术后1个月内μg·L－1，1-3个月515μg·L－1，3-6个月412μg·L－1， 6-12个月μg·L－1，＞年维持在μg·L－1。全血谷浓度，按推荐治疗窗调整给药方案，可 他克莫司 血药浓度监测 肾移植 ELISAAnalysis of the Result on the whole Blood Concentration of Tacrolimus after Kidney Transplantation WANG Chun-yan，XU Xia，JI Song-gang，LI Ming-chun(Dept. Of Pharmacy，No. 401 Hospital of PLA，Qingdao，266071，China) Abstract OBJECTIVE: By monitoring the kidney transplantation patients’ tacrolimus (FK506) concentrations, observing and establishing a proper therapeutic window in order to provide reference for clinical therapy. METHODS: The whole blood valley concentration of tacrolimus in1824 cases (74 patients, cyclosporine switching group 41 patients) were analysed by ELISA. RESULTS: The whole blood valley concentration of tacrolimus and the time switched after transplantation was negative correlation. The level was 4.92~15.54μg·L－1 in the first month, 5.29~11.15μg·L－1 in the second month and third month, 4.09~10.37μg·L－1 in the fouth month to sixth month, 3.67~8.77μg·L－1 in the seventh month to twelfth month, 3.31~8.67μg·L－1 in the thirteenth month to the second year. 2.70~8.06μg·L－1 in the third year to fifth year and 2.35~7.78μg·L－1l after the fifth year. CONCLUSION: The absorption of tacrolimus has great individual difference, the tacrolimus range of therapeutic window in renal transplant patients within one month was recommended for 5-20μg·L－1, 5 ~ 15μg·L－1 in the second month and third month, 4 ~ 12μg·L－1 in the fouth month to sixth month, 4 ~ 10μg·L－1 in the sixth month to twelfth month and 3 ~ 8μg·L－1 more than one year. In order to achieve the ideal treatment effect and reduce the side effect, the whole blo