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目的:探讨肾移植患者应用他克莫司适用群体。方法:51名患者分为老年、成年肝炎病毒携带者和成年非肝炎病毒携带者。观察初始剂量他克莫司的血药浓度和术后3个月、1年他克莫司维持剂量变化及急、慢性排斥反应发生情况。结果: 在相似的初始剂量下,老年和成年肝炎病毒携带者他克莫司血药浓度明显高于成年非携带者,而术后3个月及1年他克莫司维持剂量又明显低于成年非携带者。随着观察延迁,成年非肝炎携带者中发生2例急性排斥反应,1例慢性排斥反应,有3例因维持剂量一直偏高,难以承担昂贵药费,改用环孢素。结论:老年、成年肝炎病毒携带者术后应首选他克莫司,既减轻和避免药物副作用,药费相对无增高。
Objective: To investigate the application of tacrolimus in renal transplant recipients. Methods: Fifty-one patients were divided into elderly, adult hepatitis virus carriers and adult non-hepatitis virus carriers. To observe the initial dose of tacrolimus plasma concentration and 3 months after surgery, 1 year tacrolimus maintenance dose changes and acute and chronic rejection reactions. RESULTS: Tacrolimus plasma concentrations of elderly and adult hepatitis C virus carriers were significantly higher than those of adult non-carriers at similar initial doses, and the tacrolimus maintenance doses were significantly lower at 3 and 1 year after surgery Adult non-carriers. With the observed delay, two cases of acute rejection and one case of chronic rejection occurred in adult non-hepatitis carriers. Three patients remained on high maintenance doses and were unable to afford expensive drugs instead of cyclosporine. Conclusion: Elderly and adult hepatitis C virus carriers should be the first choice of tacrolimus after surgery, both to reduce and avoid drug side effects, relatively no increase in drug costs.