特异性荧光偏振免疫法监测 521例 肾移植后环孢素 A 全血浓度 3275 次

目的 通过监测肾移植后病人环孢素 A(CsA)全血浓度, 提出 CsA 在三联免疫抑制用药方案中的 理想治疗窗。方法 用特异性荧光偏振免疫法测定 CsA 全血浓度, 对 521例病人监测 3275 次, 按术 后时间及临床表现分组比较。结果 肾移植后 <1, 、1～ 3、3～ 6、6～ 12 个月 、1～ 2和 >2 年的 CsA 全血谷浓度的理想治疗窗应分别为 250～ 450、200～ 400、150～ 300、100～ 250、100～ 200 和 100～ 180 μg/L。结论 CsA 全血浓度在上述范围内, 中毒反应和排异反应明显减少。

Monitoring of whole blood level of cyclosporine in 3275 samples from 521 renal transplant recipients by specific fluorescence polarization immunoassay

Aim To monitor the whole blood trough concentration of cyclosporine A(CsA)in renal transplant recipients, and to suggest optimal therapeutic window of CsA. Methods CsA concentration in 3275 blood samples from 521 renal transplant recipients was measured by specific fluorescence polarization immunoassay. The whole blood trough CsA concentrations were compared according to different times after operation and clinical symptoms.Results The optimal therapeutic window of CsA should be 250～ 450 μg/L (less than 1 month after operation), 200～ 400 μg/L(1～ 3 months), 150～ 300 μg/L (3～ 6 months), 100～ 250 μg/L (6～ 12 months), 100～ 200 μ g/L(1～ 2 years), 100～ 180 μ g/L(more than 2 years), 100～ 180 μg/L(more than 2 years), respectivily. Conclusion The satistical analysis indicated that frequency of toxic effects and rejection reaction would significantly be reduced if CsA whole blood levels were adjusted to therapeutic and safe range.