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目的：考察肾移植（ＲＴ）术后不同时期环孢素Ａ（ＣｓＡ）谷浓度与肾移植效果的关系。方法：采用荧光偏振免疫（ＦＰＩＡ）法，对１２６例次ＲＴ术后０个月～２４个月的患者进行常规ＣｓＡ谷浓度监测，并结合患者临床症状进行归纳、分析、统计。结果：ＲＴ术后早期出现中毒反应的浓度为（６９８．３２±６１．８３）ｎｇ·ｍｌ－１，为有效治疗浓度最高值的１．５５倍，而后期出现中毒反应的浓度为（３６３．０８±７３．６６）ｎｇ·ｍｌ－１，为有效治疗浓度最高值的２．４２倍；术后早、后期排异反应发生率及中、后期毒性反应的发生率均有显著性差异（Ｐ＜０．０５）。结论：长期服用ＣｓＡ后患者对中毒的耐受性增加；ＲＴ术后早期排异反应发生率较后期明显，而早、后期的中毒反应发生率均较中期明显升高。由于个体差异较大，在ＲＴ术后各个时期都应加强血药浓度的监测，早期以预防排异为主，后期则以预防中毒为主。
OBJECTIVE: To investigate the relationship between CsA trough levels and renal transplantation in different stages after renal transplantation (RT). Methods: FPA was used to monitor the concentration of CsA in 126 patients from 0 months to 24 months after RT, and the induction, analysis and statistics were combined with the clinical symptoms. Results: The concentration of poisoning reaction was (698.32 ± 61.83) ng · ml-1 after RT, which was 1.55 times of the highest value of effective treatment, and the concentration of poisoning reaction was (363). 08 ± 73.66) ng · ml-1, which was 2.42 times of the highest effective concentration. There was a significant difference in the incidence of early and late postoperative rejection and the late-stage toxicities (P <0.05). CONCLUSIONS: The tolerance of patients to poisoning after long-term CsA administration is increased. The incidence of early rejection is higher than that of the later stage after RT. The incidence of early-onset and late-stage toxic reactions is significantly higher than that of the middle period. Due to the large individual differences, blood concentration monitoring should be strengthened at all stages of RT. Early prevention should be based on the prevention of rejection and the later should be prevention of poisoning.