他克莫司在肝肾联合移植患者与单纯肝移植及单纯肾移植患者之间代谢的差异  

Metabolic differences of tacrolimus between patients with combined liver and kidney transplantation and patients with single liver or single kidney transplantation

作　　者：鲁燕侠[1] 邹德勇[2] 王新[3] 严莲珍[1] 

机构地区：[1]武警总医院药剂科,北京100039 [2]武警总医院检验科,北京100039 [3]武警总医院计算机管理中心,北京100039

出　　处：《中国中西医结合急救杂志》2017年第3期304-306,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：武警总医院科研项目（WZ2012054）

摘　　要：目的 探讨他克莫司在不同器官移植受者间的代谢差异.方法 采用回顾性研究方法,选择武警总医院器官移植中心2002年1月至2012年8月收治的器官移植患者30例,分为肝肾联合移植（SLK）组、单纯肝移植组和单纯肾移植组,每组10例.SLK组与单纯肝移植组两组给药方案相同,术中均给予甲泼尼龙注射液,术后采用他克莫司＋吗替麦考酚酯＋泼尼松三联免疫抑制治疗方案.术后第1天给予他克莫司,初始剂量0.06 mg·kg-1·d-1,分2次服用,术后第3天开始检测他克莫司全血谷浓度;单纯肾移植组术后2~4 d给予他克莫司,初始剂量为0.15 mg·kg-1·d-1,分2次服用,服药3 d后开始监测他克莫司全血谷浓度.比较3组移植术后1个月内他克莫司的服药剂量和全血谷浓度.结果 术后1个月SLK组口服他克莫司剂量（μg·kg-1·d-1：74.78±32.65比80.62±24.02、85.58±16.78）及血药浓度监测值（μg/L：6.64±2.73比7.50±3.08、7.46±3.20）均低于单纯肝移植组和单纯肾移植组,但组间比较差异无统计学意义（均P〉0.05）.结论 SLK中移植肝对于移植肾的保护作用可能与术后时间有关.术后1个月内移植肝对于移植肾未显示出保护作用.Objective To investigate the metabolic differences of Tacrolimus in different transplant recipients. Methods A retrospective study was conducted, 30 patients of the organ transplant admitted to organ transplantation center of General Hospital of Chinese People＇s Armed Police Forces from January 2002 to August 2012 were enrolled, and they were divided into combined liver and kidney transplant （SLK） group, single liver transplant group and single renal transplant group, 10 cases in each group. The SLK group and the simple liver transplantation group were given the same drug regimen, methylprednisolone injection was given during operation, and tacrolimus＋ mycophenolate mofetil＋ prednisone triple immunosuppressive therapy was taken after operation, on the first day after operation, the initial dose of tacrolimus was given 0.06 mg·kg-1·d-1 divided into 2 times taken orally, and on the third day after operation, the concentration of tacrolimus was detected; after operation group for 2 - 4 days, single renal transplantation group was given tacrolimus the initial dose of tacrolimus 0.15 mg·kg-1·d-1 was divided into 2 parts for twice oral administration, after 2 - 3 days of the above treatment, monitoring the concentration of tacrolimus began. One month after transplantation, the metabolic differences of tacrolimus among the three groups were compared.Results One month after operation, the oral tacrolimus doses （μg·kg-1·d-1： 74.78±32.65 vs. 80.62±24.02, 85.58±16.78） and the monitored blood drug concentration （μg/L： 6.64±2.73 vs. 7.50±3.08, 7.46±3.20） in SLK group were lower than either the single liver transplantation group or single renal transplantation group, but the comparisons among the three groups, there were no statistically significant differences（allP 〉 0.05）.Conclusions In SLK group, the protective effect of transplanted liver on transplanted kidney may be related to the length of postoperative time. Liver transplantation performed within post-operative one month has no

关 键 词：他克莫司 肝移植 肾移植 肝肾联合移植 代谢差异 

分 类 号：R699.2[医药卫生—泌尿科学]