肾移植后FK506的监测状况  

Dynamic monitoring of FK506 in renal allograft recipients

作　　者：汪艳[1] 孙悦波[1] 

机构地区：[1]大连市友谊医院,辽宁大连116001

出　　处：《临床医药实践》2005年第6期406-407,共2页Proceeding of Clinical Medicine

摘　　要：目的:研究动态监测免疫抑制剂FK506的临床意义。方法:使用ELISA法进行全血浓度测定,监测42例使用FK506的患者在肾移植后第3天、第1周、第2周、第1个月～第4个月及第6个月的血药浓度。结果:服用FK506后测得第3天平均血药浓度为(15.3±2.2)ng/mL,第1周(16.4±2.8)ng/mL,第2周(16.1±2.5)ng/mL,第1个月(16.8±2.3)ng/mL,第2个月(11.3±1.7)ng/mL,第3个月(10.8±1.4)ng/mL,第4个月(6.8±0.9)ng/mL,第6个月(6.1±0.7)ng/mL。2例发生急性排斥反应的血药浓度明显低于正常平均浓度,3例发生肾中毒患者的血药浓度明显高于正常平均浓度,及时调整用药剂量,情况有所好转。结论:由于FK506个体差异大,治疗窗窄,极易造成急性排斥反应或肾中毒,因此,对于临床医生来说,要密切监测FK506的全血浓度,以便能够及时调整用药剂量,充分发挥免疫抑制作用,最大限度地减低毒副作用,取得肾移植的理想治疗效果,延长移植物的存活率。Objective:To study dynamic monitoring FK506 and it′s clinical value.Methods:Use ELISA to monitor the whole blood concentrations of 42 cases recipients who taked FK506 in the third day,first week,second weed,first month,second month,third month,fourth month and sixth month.Compared the differences of blood concentrations between occurred the side effects recipients and the average.Results:The whole average blood FK506 trough concentration was (15.3±2.2) ng/mL in the third day,(16.4±2.8) ng/mL in the first week,(16.1±2.5) ng/mL in the second week,(16.8±2.3) ng/mL in the first month and (11.3±1.7) ng/mL,(10.8±1.4) ng/mL,(6.8±0.9) ng/mL,(6.1±0.7) ng/mL in the second,third,fourth and sixth month.Acute rejection occurred in 2 and the average concentration is much lower than the normal average concentration;graft adverse events occurred in 3 and the average concentration is much higher than the normal concentraion.After adjusted the doses the condition turn to better.Conclusions:Because the individual differences of FK506 are large and the range of therapeutic window is narrow,so according to clinical doctors,they should monitor the whole blood concentration of FK506 closely so as to adjust the medicine dose in time.By doing so,we can conduct the immunosuppressive function fully,decrease the side effects,get ideal therapy and prolong the graft survival.

关 键 词：肾移植 免疫抑制剂 FK506 动态监测 

分 类 号：R692[医药卫生—泌尿科学]