霉酚酸对肝移植受者外周血单核细胞IMPDH活性影响.PDF

霉酚酸对肝移植受者外周血单核细胞 IMPDH 活性的影响 茅华荣 a ，张伟霞 b ，顾志冬 c ，陈冰 b ，陈皓 a*(1.上海交通大学医学院附属瑞金医院，a.器官移植中心；b.药剂科；c.检验科，上 海 200025) 摘要：目的 探讨中国肝移植受者术后早期外周血单核细胞次黄嘌呤核苷酸脱氢酶(IMPDH)活性变化与血浆霉酚酸(MPA) 浓度变化之间的相关性。方法 22 例肝移植受者术后应用他克莫司、霉酚酸酯(MMF)和糖皮质激素三联免疫抑制方案。 移植后早期采集口服 MMF 前及服药后 0.5 ，1，1.5，2 ，4 ，6 ，8 ，10，12 h 外周血，检测 MPA 血药浓度，同时测定口服 MMF 前及后 1，2 h 外周血单核细胞 IMPDH 活性。结果 肝移植受者外周血单核细胞 IMPDH 活性存在个体间差异，与 血浆 MPA 浓度之间呈显著负相关(P0.05) 。与服药前相比，服药后 1 h IMPDH 活性显著下降(P0.05) 。结论 肝移植受 者口服 MMF 后外周血单核细胞 IMPDH 活性显著下降，可以作为 MPA 药效学监测指标。 关键词：次黄嘌呤核苷酸脱氢酶；霉酚酸酯；霉酚酸；肝移植 中图分类号：R969.11 文献标志码：A 文章编号：1007-7693(2010)11-1043-04 Effects of Mycophenolic Acid on IMPDH Activity in Peripheral Blood Mononuclear Cells in Liver Transplant Patients a b c b a* MAO Huarong , ZHANG Weixia , GU Zhidong , CHEN Bing , CHEN Hao (Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, a.Center of Organ Transplantation; b.Institute of Clinical Pharmacology; c.Department of Laboratory, Shanghai 200025, China) ABSTRACT: OBJECTIVE To determine the relationship between mycophenolic acid (MPA) concentrations and inosine monophosphate dehydrogenase (IMPDH) activity in peripheral blood mononuclear cells (PBMC) in liver transplant patients. METHODS Twenty-two liver transplant patients received mycophenolate mofetil (MMF) in combination with tacrolimus and steroids were enrolled. For investigating MPA pharmacokinetic profile, plasma MPA concentrations was monitored before MMF dosing and at 0.5, 1, 1.5, 2, 4, 6, 8, 10, 12 h after MMF dosing during the early period after transplantation, and the IMPDH activity on mononuclear cells was measured before dosing and at 1, 2 h after dosing.