CYP3A5基因多态性对肾移植受者他克莫司谷浓度及肾功能恢复的影响  

Effects of CYP3A5 gene polymorphism on the trough concentration of tacrolimus and the recovery of renal function in renal transplant recipients

作　　者：石丽娟 胡津鹏 陈妍 孙秀漫[1] 曾彩芳[1] SHI Li-juan;HU Jin-peng;CHEN Yan(The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 511447,China;不详)

机构地区：[1]广州医科大学附属第二医院,广州511447 [2]广州医科大学,广州511436

出　　处：《中国处方药》2022年第6期22-24,共3页Journal of China Prescription Drug

摘　　要：目的 研究比较三种不同CYP3A5基因型的肾移植受者的他克莫司谷浓度及肾功能恢复的差异,为临床他克莫司初始剂量的选择提供参考。方法 选取156例首次肾移植并采用以他克莫司为基础的免疫抑制方案的肾移植受者,按照CYP3A5基因型的不同分为*1/*1、*1/*3、*3/*3共三组,分别对比术后首次测得他克莫司谷浓度(C_(0))以及他克莫司浓度/剂量(C_(0)/D)值;通过观察不同基因型肾移植受者术前、术后第1次、术后第1周及术后第2周血肌酐值,以及是否出现急性排斥,评估患者移植肾功能恢复情况。结果 *3/*3与*1/*1、*1/*3基因型受者他克莫司C_(0)以及C_(0)/D均有显著差异(P=0.000,0.000),*1/*1与*1/*3、*3/*3术后第1周肌酐有显著性差异(P=0.012,0.004);不同基因型发生急性排斥反应的比例相近。结论 肾移植受者他克莫司C_(0)受CYP3A5基因多态性的影响显著。CYP3A5*3/*3基因型的肾移植受者体内他克莫司C_(0)偏高,其他克莫司初始剂量需减量,避免因他克莫司血药浓度过高而延迟移植肾功能的恢复。Objective Compare the trough concentration of tacrolimus and the recovery of renal function with three different CYP3A5 genotypes in renal transplant recipients,and to provide reference for the selection of initial dose of tacrolimus in clinic.Methods A total of 156 recipients with tacrolimus based immunosuppression were selected and divided into three groups according to CYP3A5 genotype:*1/*1,*1/*3,and *3/*3.The C_(0) and C_(0)/D values of tacrolimus were compared after the kidney transplant operation.The renal function recovery of different genotypes of renal transplant recipients was evaluated by observing the serum creatinine values before and after the operation,one week and two weeks after the operation,and whether acute rejection occurred.Results The C_(0) and C_(0)/D values of tacrolimus were significant difference between *3/*3 and *1/*1,*1/*3 genotypes(P = 0.000,0.000),and the serum creatinine values were significant differently between *1/*1 and *1/*3,*3/*3 genotypes(P = 0.012,0.004) after one week of renal transplant;The proportion of acute rejection was similar among different genotypes.Conclusion The trough concentration of tacrolimus in renal transplant recipients is significantly affected by the polymorphism of CYP3A5 gene.The trough concentration of tacrolimus in patients with CYP3A5*3/*3 genotype is higher,and the initial dose of tacrolimus can be slightly reduced to avoid the delayed recovery of transplanted renal function due to the high trough concentration of tacrolimus.

关 键 词：肾移植 CYP3A5基因多态性 他克莫司谷浓度 肾功能恢复 

分 类 号：R969.1[医药卫生—药理学]