肾移植患者他克莫司谷浓度和2 h血药浓度监测的临床意义

摘要

目的 探讨血药谷浓度(C0)和2h血药浓度(C2)监测对肾移植患者个体化用药的指导作用.方法 对肾移植术后服用他克莫司(FK506)的19例患者,监测其C0和C2及肝肾功能等指标的变化情况.结果 不同个体间C0和C2差异很大,同一个体不同时间内C0和C2差异也很大,尤其是腹泻患者有时会有C0大于C2的情况发生.因此,临床需设计个体化的给药方案.结论 C0和C2监测对于调整给药剂量及用药间隔时间、减少排斥反应及肾毒性的发生、使患者用药更具个体化具有重要意义.%Objective To study the guidance role of monitoring the trough level (C0) and the 2h level (C2) of the blood drug concentration for the individualized medication in renal-transplant patients.Methods 19 patients after renal transplant took tacrolimus (FK506) and were monitored the changes of blood drug concentration (C0 and C2) and the indexes of live and kidney functions.Methods There were great differences in C0 and C2 among individuals.But the same individual also had great difference in C0 and C2 at different time,especially in the patients with diarrhea,sometimes the situation of C0 ＞ C2 could ocurred.Therefore,the individualized medication scheme should be designed in clinic.Conclusion The monitoring of C0 and C2 has an important significance to adjust dosage and dosing interval,reduce the occurrence of rejection reactions and renal toxicity,and make the medication more individualized.