初步探讨他克莫司(FK506)对肝移植受者的治疗窗浓度及其与年龄、性别的关系  

Required level of tacrolimus in liver transplant recipients and the correlation to age and sex

作　　者：周金生[1] 冯少青[1] 陈元俊[1] 

机构地区：[1]解放军第180医院,泉州362000

出　　处：《药学与临床研究》2008年第2期137-139,共3页Pharmaceutical and Clinical Research

摘　　要：目的：探讨适合我国肝移植受者他克莫司理想治疗窗浓度范围及其与年龄、性别的关系。方法：应用微粒子酶免分析法测定75例不同年龄、性别肝移植受者口服他克莫司后12h的血药谷浓度，并观察排斥反应的发生及药物不良反应。结果：他克莫司的血药浓度，术后第1个月为11．3～15．5ng·mL^-1，第2、3个月为7．8～10．7ng·mL^-1，3个月后为5．3～7．8ng·mL^-1，比较不同时期全血他克莫司的谷浓度，均有显著差异（P〈0．01）。术后发生排斥反应64例次，不良反应73例次。结论：建议他克莫司治疗窗浓度范围改为：术后第1个月为10～15ng·mL^-1，第2，3个月为7．0—11ng·mL^-1，3月后为5.0～8．0ng·mL^-1维持；此浓度范围既能达到满意的免疫抑制效果，又能减少他克莫司的不良反应，并观察到其浓度与年龄、性别有一定的相关性。Objective ：To search for a proper therapeutic window concentration of tacrolimus （FK506） in Chinese liver transplant recipients and the relationship to age and sex. Methods： Blook sample were taken 12h after oral FK506 administration in 75 patients and were assayed by means of MEIA,the occurrence of rejection and the drug toxicity were observed. Results： The blood FK506 eoneertration was 11.3 ～15.5 ng· mL^-1 within the first postoperative month, 7.8 ～10.7ng· mL^-1 within the second to third postoperative month, and 5.3 ～7.8 ng· mL^-1 from the fourth month after transplantation, with the difference among the different intervals being very significant（P 〈 0.01 ）. There were 64 case times of rejection and 73 case times drug toxicity. Conclusions： The whole blood FK506 through level was 10 ～15 ng· mL^-1 within the first month, 7.0 ～ 11.0 ng· mL^-1 in the second and third month,5.0 ～ 8.0 ng· mL^-1 from the fourth month after transplantation. This range of therapeutic window concentration of FK506 through levels was ideal for Chinese liver transplant recipients with less rejection and toxic effects and the concentration has some relationship to age and sex.

关 键 词：他克莫司 肝移植 血药浓度监测 

分 类 号：R969.4[医药卫生—药理学]