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目的 观察环孢素血药浓度与肾移植效果间关系。方法 对９７例接受同种异体肾脏移植术受者术后８周内２０６例次环孢素血药浓度监测结果进行回顾性分析，按照受者术后的临床表现、生化指标将其分为术后正常组、急性排斥组、急性毒性组，采用荧光偏振免疫测定法，以单克隆抗体试剂测定环孢素血药浓度。结果 术后正常组６２例移植肾功能良好，环孢素的给药剂量为５２±１．９ ｍｇ／ｋｇ·ｄ，１７１例次环孢素血药浓度的平均值为３０９．８５±１３１．６９μｇ／Ｌ；术后急性排斥组 ２６例，距发生排斥反应最近一次的环孢素血药浓度平均为１６５．８０±１２３．１３μｇ／Ｌ，环孢素的给药剂量为 ４．８±１．６ｍｇ／ｋｇ·ｄ；术后急性毒性组９例，距发生毒性反应最近一次的环孢素血药浓度平均为５５６．５１±１０２．５０μｇ／Ｌ，环孢素的给药剂量为６．２±１．０ｍｇ／ｋｇ·ｄ。三组之间环孢素的给药剂量无显著性差异（Ｐ＞０．０５），但环孢素血药浓度却相差很大，两两之间有显著性差异（正常组与排斥组 Ｐ＜ ０．０５；正常组与毒性组Ｐ＜ ０．０５；排斥组与毒性组Ｐ＜ ０．０１）。结论 环孢素浓度较低时，出现排斥反应的可能性较大；而环孢素浓度较高时，发生毒性反应的机会较多。
Objective To observe the relationship between cyclosporine blood concentration and renal transplantation. Methods A total of 97 patients undergoing renal allograft recipients were retrospectively analyzed for 206 cyclosporine blood concentrations within 8 weeks after surgery. According to the postoperative clinical manifestations and biochemical indexes, the patients were divided into two groups After normal group, acute rejection group and acute toxicity group, the plasma concentration of cyclosporine was determined by fluorescence polarization immunoassay with monoclonal antibody reagent. Results In the normal group, the function of graft kidney was good in 62 cases, the dose of cyclosporine was 52 ± 1.9 mg / kg · d, and the average value of 171 cases of cyclosporine was 309.85 ± 131. 69 μg / L; in the group of acute rejection after operation, the average concentration of cyclosporine in 16 patients was 165.80 ± 123.13 μg / L and that of cyclosporine was 4.8 ± 1 .6mg / kg · d; acute toxicity group after operation in 9 cases, from the occurrence of the most recent toxicity of cyclosporine plasma concentration average of 556.51 ± 102.50μg / L, cyclosporine dose of 6. 2 ± 1.0 mg / kg · d. There was no significant difference in the dose of cyclosporine among the three groups (P> 0.05), but there was a great difference between the two groups in plasma concentrations of cyclosporine (P <0.05) <0.05; normal group and toxicity group P <0.05; rejection group and toxicity group P <0.01). Conclusions When the concentration of cyclosporine is low, there is a high possibility of rejection. When the concentration of cyclosporine is high, there is more chance of toxicity.