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目的:为了避免他克莫司的不良反应,对使用他克莫司的肝移植患者实施治疗药物监测。方法:用微粒子酶免疫法测定全血他克莫司谷浓度,并对他克莫司谷浓度的监测结果进行回顾性分析。结果:当肝移植患者被给予他克莫司、泼尼松和硫唑嘌呤时,他克莫司谷浓度与剂量之间存在正相相关。为了得到理想的效果和最小的毒性,他克莫司的全血药物浓度在肝移植后的90d内应维持在10～20μg·L~(-1),90d后在5～15μg·L~(-1)。结论:对于肝移植患者,他克莫司的全血药物浓度监测是很必要的,而且对于减少毒性和排斥反应的危险性是很有帮助的。
OBJECTIVE: To avoid the adverse reactions of tacrolimus, therapeutic drug monitoring was performed in patients undergoing liver transplantation with tacrolimus. Methods: Whole blood tacrolimus concentration was determined by microparticle enzyme immunoassay. The monitoring results of tacrolimus concentration were retrospectively analyzed. Results: There was a positive correlation between tacrolimus concentration and dose when liver transplant recipients were given tacrolimus, prednisone and azathioprine. In order to achieve the desired effect and minimal toxicity, the tacrolimus whole blood drug concentration in the 90d after liver transplantation should be maintained at 10 ~ 20μg · L -1, 90d after 5 ~ 15μg · L ~ (- 1). CONCLUSIONS: Tacrolimus whole blood drug concentration monitoring is necessary for patients with liver transplantation and is helpful in reducing the risk of toxicity and rejection.