他克莫司个体内浓度变异度与肝肾移植预后关系的研究进展  

Advances in the Relationship between the Variation in Tacrolimus Trough Concentration and the Prognosis of Liver and Kidney Transplantation

作　　者：孟中如 朱怀军[2] 葛卫红[1,2] MENG Zhongru1,2,ZHU Huaijun2,GE Weihong1,2(1College of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, China; 2 Department of Pharmacy, Gulou Hospital, Nanjing University, Nanjing 210008, Chin)

机构地区：[1]中国药科大学基础医学与临床药学院,南京211198 [2]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《药学与临床研究》2018年第4期278-280,286,共4页Pharmaceutical and Clinical Research

基　　金：国家自然科学基金青年科学基金项目(81302849);江苏省十三五"科教强卫工程"青年医学人才项目(QNRC2016013)

摘　　要：他克莫司是肝肾移植患者首选免疫抑制剂之一,显著降低了急性排斥发生率,但对移植长期预后并没有明显效果。他克莫司治疗窗狭窄且药动学个体间差异较大,目前尚未找到他克莫司最优的使用方法。近期有研究称,他克莫司个体内浓度变异性与肝肾移植患者的长期预后有关。本文综述衡量他克莫司个体内浓度变异度的指标,探讨个体内变异度高低对术后急性排斥、移植物失功和慢性移植肾肾病发生率的影响,为他克莫司个体内浓度变异性作为移植预后评价手段提供支持和建议。Tacrolimus is one of the most commonly used immunosuppressants in patients with liver and kidney transplantation,which reduces the incidence of acute rejection significantly,but has no significant effect on the long-term prognosis.Its therapeutic window is narrow and inter-individual pharmacokinetics differs greatly.So far,the optimal use of tacrolimus has not been found.Recent studies suggested that intra-individual variability in tacrolimus trough concentration was associated with long-term prognosis in patients with liver and kidney transplantation.Here,we reviewed the indexes used to measure the intra-individual variation and investigated the effect of variation on the incidence of acute rejection,graft loss and chronic allograft nephropathy after transplantation.We sought to provide support and recommendation for within-patient concentration variability as a tool to evaluate the prognosis.

关 键 词：他克莫司 个体内变异性 器官移植 预后 

分 类 号：R979.5[医药卫生—药品]