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目的 :探讨环孢素A(CsA)对移植肾的早期毒性与其血清浓度的相关性及对急性CaA肾中毒的诊断与治疗。方法 :回顾性地对 12例肾移植术后发生CsA毒性反应患者的CsA服用剂量和全血CsA浓度进行分析 ,拟诊CsA肾毒性反应后联合应用骁悉 (MMF)并减少CsA用量 ,观察肾功能恢复情况。结果 :12例发生CsA肾中毒患者的CsA服用剂量均超过 8mg/ (kg·d) ,其中 8例 (70 %)血清CsA谷值浓度超过 40 0 μg/L(HPLC法 )。经过减少CsA用量并联合应用MMF ,12例发生CsA肾中毒患者的肾功能都有不同程度的改善。结论 :长时间服用CsA剂量过大是引起CsA肾毒性反应的主要原因 ,减少CsA用量是有效减少CsA对移植肾毒性的有效方法 ,改硫唑嘌呤为MMF可有效防止因CsA的低剂量而致的排斥反应。
Objective: To investigate the correlation between cyclosporin A (CsA) early renal toxicity and serum concentration and the diagnosis and treatment of acute CaA nephrotoxicity. Methods: CsA dose and whole blood CsA concentration in 12 patients who underwent CsA toxicity after renal transplantation were retrospectively analyzed. Combined use of MMF and CsA dose after CsA nephrotoxic response was evaluated. Functional recovery. Results: The CsA dosage of 12 patients with CsA nephrotoxicity exceeded 8mg / (kg · d), and the serum concentration of CsA in 8 patients (70%) exceeded 40 0 μg / L (HPLC method). After reducing the amount of CsA combined with the application of MMF, 12 cases of CsA renal toxicity in patients with renal function have varying degrees of improvement. CONCLUSIONS: Long-term administration of CsA is the main reason causing CsA nephrotoxicity. Reducing the dosage of CsA is an effective way to reduce the toxic effect of CsA on renal allograft nephropathy. Using azathioprine as MMF can effectively prevent the low dose of CsA Rejection reaction