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性别对肾移植受体霉酚酸血药浓度影响的临床分析

曾维胜 李珍 宋秘 张长升 祝敏 曾云俊

曾维胜, 李珍, 宋秘, 等. 性别对肾移植受体霉酚酸血药浓度影响的临床分析[J]. 器官移植, 2018, 9(5): 385-389. doi: 10.3969/j.issn.1674-7445.2018.05.011
引用本文: 曾维胜, 李珍, 宋秘, 等. 性别对肾移植受体霉酚酸血药浓度影响的临床分析[J]. 器官移植, 2018, 9(5): 385-389. doi: 10.3969/j.issn.1674-7445.2018.05.011
Zeng Weisheng, Li Zhen, Song Mi, et al. Clinical analysis of the influence of gender on blood concentration of mycophenolic acid in recipients undergoing renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(5): 385-389. doi: 10.3969/j.issn.1674-7445.2018.05.011
Citation: Zeng Weisheng, Li Zhen, Song Mi, et al. Clinical analysis of the influence of gender on blood concentration of mycophenolic acid in recipients undergoing renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(5): 385-389. doi: 10.3969/j.issn.1674-7445.2018.05.011

性别对肾移植受体霉酚酸血药浓度影响的临床分析

doi: 10.3969/j.issn.1674-7445.2018.05.011
基金项目: 

云南省科技厅-昆明医科大学应用基础研究联合专项 2017FE467(-036)

详细信息
    作者简介:

    曾维胜, 男, 1990年生, 硕士研究生, 研究方向为器官移植, Email:1445356997@qq.com

    通讯作者:

    李珍, 女, 1983年生, 硕士, 主管护师, 研究方向为外科护理, Email:24225695@qq.com

  • 中图分类号: R617

Clinical analysis of the influence of gender on blood concentration of mycophenolic acid in recipients undergoing renal transplantation

More Information
  • 摘要:   目的  探讨性别对肾移植术后受体霉酚酸(MPA)血药浓度的影响。  方法  以115例接受活体肾移植的受体作为研究对象, 根据性别将受体分为两组, 男性为S1组(61例), 女性为S2组(54例)。术后采用他克莫司(每次2 mg, 每日2次)+吗替麦考酚酯(MMF, 每次0.75 g, 每日2次)+泼尼松三联免疫抑制方案至少1周, 检测两组受体服药后1、2、3周和1、2、3个月的MPA血药谷浓度。分析两组受体不良反应发生情况。  结果  服药后1、2、3周和1、2、3个月, S1组受体的MPA血药谷浓度均低于S2组, 差异均有统计学意义(均为P < 0.05)。服药后不同时间点S1组与S2组受体MPA血药谷浓度均数的比值较稳定, 波动在0.71~0.84。S1组MPA血药谷浓度 < 1.0 μg/mL者的例数较多, 尤其是服药后1、2周, 达到44%、20%, 而S2组MPA血药谷浓度 > 3.5 μg/mL者的例数较多, 波动在30%~78%。S1组中4例发生急性排斥反应, 其中3例因急性排斥反应导致移植物失功; S2组中7例发生胃肠道紊乱, 3例发生肺部感染。  结论   性别对于肾移植受体术后服用MPA类药物的血药浓度有一定影响, 女性受体术后MPA血药谷浓度明显高于男性受体。

     

  • 图  1  两组受体服药后不同时间MPA血药谷浓度均数的比值

    Figure  1.  The ratio of MPA trough blood concentration of recipients at different time after drug administration between two groups

    表  1  两组受体服药后不同时间MPA血药谷浓度的比较

    Table  1.   Comparison of MPA trough blood concentration of recipients at different time after drug administration between two groups(x±s, μg/mL)

    组别 n 服药后时间
    1周 2周 3周 1个月 2个月 3个月
    S1组 61 1.8±1.7 2.2±1.5 2.9±1.5 3.1±1.7 3.4±1.8 3.8±1.9
    S2组 54 2.5±1.9 2.8±1.5 3.6±1.8 4.2±2.0 4.4±2.1 4.6±1.6
    P < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05
    下载: 导出CSV

    表  2  两组受体服药后不同时间MPA血药谷浓度<1.0 μg/mL与>3.5 μg/mL的例数分布

    Table  2.   The case distribution of MPA trough blood concentration of recipients less than 1.0 μg/mL and greater than 3.5 μg/mL at different time after drug administration in the two groups[n(%)]

    MPA血药谷浓度 S1组(n=61) S2组(n=54)
    服药后1周
       < 1.0 μg/mL 27(44) 15(28)
       > 3.5 μg/mL 10(16) 16(30)
    服药后2周
       < 1.0 μg/mL 12(20) 10(19)
       > 3.5 μg/mL 8(13) 20(37)
    服药后3周
       < 1.0 μg/mL 4(7)0 1(2)0
       > 3.5 μg/mL 20(33) 24(44)
    服药后1个月
       < 1.0 μg/mL 2(3)0 0
       > 3.5 μg/mL 19(31) 26(48)
    服药后2个月
       < 1.0 μg/mL 3(5)0 0
       > 3.5 μg/mL 27(44) 32(59)
    服药后3个月
       < 1.0 μg/mL 2(3)0 1(2)0
       > 3.5 μg/mL 32(52) 42(78)
    下载: 导出CSV

    表  3  两组受体服药后不良反应的发生情况

    Table  3.   Occurrence of adverse reactions in recipients after drug administration between two groups [n (%)]

    组别 n 不良反应
    移植物失功 急性排斥反应 感染 胃肠道紊乱 其他
    S1组 61 3(5) 4(7) 1(2) 3(5)0 1(2)
    S2组 54 1(2) 1(2) 3(6) 7(13) 0
    下载: 导出CSV
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出版历程
  • 收稿日期:  2018-06-28
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2018-09-15

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