肝移植术后排斥合并高血糖的诊治和用药的实践与思考  

Diagnosis and individualized drug therapy for the rejection with hyperglycemia after liver Transplantation

作　　者：陈以宁 肖云 韩晓雨 黄璐璐[1,2,3] 马景胜 熊寒斌[1] 傅毓 汪保林 郭晓晖 钟林 敖检根[1] 何佳珂[1,2,3,4,5] CHEN Yining;XIAO Yun;HAN Xiaoyu;HUANG Lulu;MA Jingsheng;XIONG Hanbin;FU Yu;WANG Baolin;GUO Xiaohui;ZHONG Lin;AO Jiangen;HE Jiake(Department of Pharmacy,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Institute of Clinical Pharmacology,Nanchang University,Nanchang 330031,Jiangxi,China;School of Pharmacy,Nanchang University,Nanchang 330006,Jiangxi,China;Department of Organ Transplantation,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Pharmacy,Nanchang County People's Hospital,Nanchang 330200,Jiangxi,China)

机构地区：[1]南昌大学第二附属医院药学部,江西南昌330006 [2]南昌大学临床药理研究所,江西南昌330031 [3]南昌大学药学院,江西南昌330006 [4]南昌大学第二附属医院器官移植科,江西南昌330006 [5]南昌县人民医院药剂科,江西南昌330200

出　　处：《中国临床药理学与治疗学》2023年第5期550-555,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金(82160707,82060677,81603188);中华医学会临床药学分会-吴阶平基金会科研基金(LCYX-Q006/320.6750.19090-16);江西省自然科学基金青年重点/一般项目(20202ACB216005);江西省主要学科学术和技术带头人培养计划-青年人才项目(20204BCJL23053)。

摘　　要：目的:为肝移植术后发生排斥反应合并高血糖的患者建立个体化用药策略。方法:临床药师参与1例肝移植术后发生排斥反应、并发高血糖患者的诊治过程,与医生通力协作,根据患者肝功能变化,利用治疗药物监测和他克莫司-五酯胶囊临床药物相互作用,及时调整给药方案,改善患者预后。结果:该患者排斥反应和高血糖得以纠正,恢复良好,顺利出院。结论:临床药师应积极参与临床诊疗,为患者制定个体化用药策略,降低免疫抑制剂毒副作用,减少不良事件发生,提升患者移植“后时代”的长期生存质量。AIM:To establish individualized drug therapy strategy for patients with rejection and hy-perglycemia after liver transplantation.METHODS:Clinical pharmacist collaborated with the surgeons and participated in the diagnosis and treatment of rejection and hyperglycemia after liver transplanta-tion.Taking together liver function,therapeutic drug monitoring,drug-drug interactions between tacrolimus and wuzhi capsule,individualized drug therapy was adapted to improve the prognosis.RE-SULTS:The patient recovered well and survived in good health till now.CONCLUSION:It is highly sug-gested that clinical pharmacists actively involved in treatment of more severe and difficult-to-treat dis-ease and design the individualized dosing regi-mens.This will largely contribute in reduced ad-verse drug reaction,improved safety and effective-ness in drug use as well as the quality of life in the"post-transplantation era".

关 键 词：肝移植术后 排斥反应 高血糖 个体化用药 

分 类 号：R9[医药卫生—药学] R657.31