CYP3A5基因多态性指导他克莫司用药在肾移植术后中的应用价值  

Application value of CYP3A5 gene polymorphism to guide tacrolimus administration in post-renal transplantation

作　　者：杨霞 YANG Xia(Shanxi Human Organ Acquisition and Distribution Service Center,Taiyuan,Shanxi,030000,China)

机构地区：[1]山西省人体器官获取与分配服务中心,山西太原030000

出　　处：《中国冶金工业医学杂志》2023年第4期375-377,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的分析肾移植患者术后采取CYP3A5基因多态性指导他克莫司用药的临床价值。方法选取2020年6月—2022年1月于我院首次接受肾移植手术的60例患者为研究对象,根据不同用药方案将其分为对照组和观察组,每组各30例。两组均于术后第1 d根据经验予以他克莫司治疗,初始剂量为4.0 mg/d。观察组则在术后第3 d根据不同CYP3A5基因分型,对他克莫司剂量予以调整,其中,AA、AG型均调整剂量为0.12 mg/(kg·d),GG型调整剂量为0.06 mg/(kg·d)。对照组则根据他克莫司血药浓度检测结果对用药剂量予以调整。对比两组患者术后第5 d时他克莫司靶浓度达到3~8μg/L的例数、时间以及术后2周内他克莫司用药剂量调整次数。结果观察组患者术后第5 d时他克莫司达到靶浓度3~8μg/L的例数高于对照组,两组比较差异有统计学意义(χ^(2)=4.800,P<0.05)。观察组达到靶浓度3~8μg/L的时间短于对照组,两组比较差异有统计学意义(t=8.313,P<0.05)。术后2周内,对照组他克莫司用药剂量调整次数明显高于观察组,两组比较差异有统计学意义(χ^(2)=30.240,P<0.05)。结论肾移植患者术后根据CYP3A5基因型对他克莫司用药予以多态性指导较传统经验用药而言,更有利于患者术后尽快达到血药浓度水平,提高预后效果,值得推广。Objective To analyze the clinical value of using CYP3A5 gene polymorphism to guide tacrolimus administration in post-renal transplantation.Methods A total of 60 patients of renal transplantation during June 2020 to January 2022 were selected as the research objects,were divided into control group and observation group with 30 cases in each group according to different dosing regimens.In the two groups,tacrolimus was administered empirically at dose of 4.0 mg/d on postoperative day 1.In the observation group,the dose of tacrolimus was adjusted according to different CYP3A5 genotypes on postoperative day 3,including 0.12 mg/(kg d)for AA and AG types and 0.06 mg/(kg d)for GG type.In the control group,the dose was adjusted according to the results of tacrolimus blood concentration test.The number of patients in the two groups who reached the target concentration of tacrolimus of 3~8μg/L by the 5th postoperative day,the time and the number of tacrolimus dose adjustments within 2 weeks after surgery were compared.Results The number of patients in the observation group who reached the target concentration of tacrolimus 3~8μg/L at the 5th postoperative day was higher than that in the control group,and the difference between the two groups was statistically significant(χ^(2)=4.800,P<0.05).The time to reach the target concentration of 3~8μg/L in the observation group was shorter than that in the control group,and the difference between the two groups was statistically significant(t=8.313,P<0.05).The number of tacrolimus dose adjustments was significantly higher in the control group than in the observation group within 2 weeks after surgery,and the difference between the two groups was statistically significant(χ^(2)=30.240,P<0.05).Conclusion The polymorphism guidance of tacrolimus according to the CYP3A5 genotype after renal transplantation is more beneficial to achieve the serum concentration level as soon as possible after surgery and to improve the prognosis than traditional empirical dosing,which is worth promotin

关 键 词：CYP3A5基因多态性 肾移植术后 他克莫司 血药浓度 

分 类 号：R699.2[医药卫生—泌尿科学]