肝移植术后他克莫司浓度/剂量的影响因素及变化规律  

Influential Factors and Regulation of FK506 C/D after Liver Transplantation

作　　者：谭昀杜熙 黄磊[2] 杨薇[1] 胡志平[2] 

机构地区：[1]北京大学人民医院药剂科,北京100044 [2]北京大学人民医院肝胆外科,北京100044

出　　处：《中国药房》2013年第42期3964-3966,共3页China Pharmacy

基　　金：北京大学人民医院研究与发展基金(No.2009)

摘　　要：目的:考察肝移植术后不同时期他克莫司(FK506)血药浓度/千克体质量日剂量(C/D)的影响因素及变化规律。方法:随访2010-2011年在北京大学人民医院行肝移植术的患者35例,测定供受体CYP3A5、MDR1基因多态性,记录患者身高(H)、体质量(W)及术后3、7、14、30、60 d的相关化验指标包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素(DB)、血红蛋白(Hbg)、红细胞比容(HCT)、白蛋白(ALB)、血肌酐(Cr)及FK506浓度值,利用SPSS 17.0软件对数据进行多元回归分析。结果:C/D受多种因素影响且肝移植术后不同时期主要影响因素不同,术后3 d与胆红素、肌酐水平密切相关;术后14、30、60 d时的主要因素分别为体质量、多耐药基因、身高与体质量。结论:肝移植术后免疫抑制管理需考虑众多影响因素,且不同时期各影响因素所占权重不同;早期与肝功能关系较为密切,稳定期与机体本身关系较大,宜实行精细化管理。OBJECTIVE： To investigate the main influential factors and regulation of FK506 C/D after liver transplantation. METHODS： 35 patients underwent liver transplantation were followed up during 2010--2011. CYP3A5 and MDR1 gene polymor- phisms were identified in the donors and recipients. The values of height （H）, weight （W）, ALT, AST, TB, DB, Hbg, HCT, ALB, Cr and FKS06 concentration were recorded on 3 d, 7 d, 14 d, 30 d and 60 d after operation, and SPSS 17.0 software was used to analyze all data. RESULTS： FKS06 C/D was influenced by various factors, and main influential factors were different in different periods. FKS06 C/D was influenced by bilirubin and ereatinine closely 3 days after operation. The main influential factors were W, multidrug resistant gene, W and H 14 d, 30 d and 60 d after operation. CONCLUSIONS： Multiple influential factors should be considered for immunologic suppression management after liver transplantation. The weights of influential factors are dif- ferent in different periods. FKS06 C/D is closely associated with liver function, at early stage, while is significantly associated with the body at stable phase, and it is suitable to conduct fine management.

关 键 词：肝移植术 他克莫司 浓度 剂量 影响因素 变化规律 

分 类 号：R979.5[医药卫生—药品] R969.3[医药卫生—药学]