摘要
目的:考察肝移植术后不同时期他克莫司(FK506)血药浓度/千克体质量日剂量(C/D)的影响因素及变化规律。方法:随访2010-2011年在北京大学人民医院行肝移植术的患者35例,测定供受体CYP3A5、MDR1基因多态性,记录患者身高(H)、体质量(W)及术后3、7、14、30、60 d的相关化验指标包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素(DB)、血红蛋白(Hbg)、红细胞比容(HCT)、白蛋白(ALB)、血肌酐(Cr)及FK506浓度值,利用SPSS 17.0软件对数据进行多元回归分析。结果:C/D受多种因素影响且肝移植术后不同时期主要影响因素不同,术后3 d与胆红素、肌酐水平密切相关;术后14、30、60 d时的主要因素分别为体质量、多耐药基因、身高与体质量。结论:肝移植术后免疫抑制管理需考虑众多影响因素,且不同时期各影响因素所占权重不同;早期与肝功能关系较为密切,稳定期与机体本身关系较大,宜实行精细化管理。
OBJECTIVE： To investigate the main influential factors and regulation of FK506 C/D after liver transplantation. METHODS： 35 patients underwent liver transplantation were followed up during 2010--2011. CYP3A5 and MDR1 gene polymor- phisms were identified in the donors and recipients. The values of height （H）, weight （W）, ALT, AST, TB, DB, Hbg, HCT, ALB, Cr and FKS06 concentration were recorded on 3 d, 7 d, 14 d, 30 d and 60 d after operation, and SPSS 17.0 software was used to analyze all data. RESULTS： FKS06 C/D was influenced by various factors, and main influential factors were different in different periods. FKS06 C/D was influenced by bilirubin and ereatinine closely 3 days after operation. The main influential factors were W, multidrug resistant gene, W and H 14 d, 30 d and 60 d after operation. CONCLUSIONS： Multiple influential factors should be considered for immunologic suppression management after liver transplantation. The weights of influential factors are dif- ferent in different periods. FKS06 C/D is closely associated with liver function, at early stage, while is significantly associated with the body at stable phase, and it is suitable to conduct fine management.
出处
《中国药房》
CAS
CSCD
2013年第42期3964-3966,共3页
China Pharmacy
基金
北京大学人民医院研究与发展基金(No.2009)
