南方医科大学学报 ›› 2017, Vol. 37 ›› Issue (06): 817-.

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肾移植术后患者他克莫司血药浓度与血清胱抑素C的相关性及其对糖脂代谢的影响

钟震帮,莫立乾,陈艳,郑萍,杨西晓   

  • 出版日期:2017-06-20 发布日期:2017-06-20

Correlation of blood concentration of tacrolimus with serum cystatin C in renal transplant recipients and effect of tacrolimus on glucose and lipid metabolism

  • Online:2017-06-20 Published:2017-06-20

摘要: 目的探讨肾移植术后患者服用他克莫司(FK506)后的血药浓度与血清胱抑素C(Cys C)的相关性及他克莫司对患者糖脂 代谢的影响。方法收集2014年8月~2015年9月我院肾移植术后监测FK506血药浓度的325例随访患者,根据术后时间分为4 组(术后1月组、术后1~3月组、术后4~6月组、术后7~12月组),记录术后定期复查时的FK506谷浓度,并同时记录当天肌酐、 Cys C、空腹血糖以及血脂水平。结果FK506血药浓度随着年龄的增长呈降低的趋势,且FK506血药浓度与Cys C呈显著正相 关(r=0.985,P=0.015),与肌酐无相关性(r=0.259,P=0.741),而FK506对肾移植术后1~6月患者的血糖(5.53~5.59 mmol/L)、血 脂(甘油三酯1.47~1.55 mmol/L、总胆固醇5.04~5.17 mmol/L、低密度脂蛋白胆固醇3.00~3.07 mmol/L、极低密度脂蛋白0.73~ 0.76 mmol/L)无影响。结论FK506不影响肾移植术后患者糖脂代谢水平,FK506在得到更加准确合理的应用,有助于提高其 在肾移植患者中治疗的有效性和安全性。

Abstract: Objective To investigate the correlation between blood concentrations of tacrolimus (FK506) and cystatin C (Cys C) and the effect of FK506 on glycolipid metabolism in renal transplant recipients. Methods A total of 325 patients receiving renal transplantation between August, 2014 and September, 2015 in Nanfang Hospital were divided into 4 groups according to the postoperative time (1 month group, 1-3 months group, 4-6 months group, and 7-12 months group). FK506 blood trough concentration was measured at the time of postoperative follow-up, and creatinine (Scr) and Cys C levels were also detected. Results Plasma FK506 concentration decreased with age in the recipients and showed a positive correlation with Cys C (r= 0.985, P=0.015) but no obvious correlation with Scr (r=0.259, P=0.741). FK506 had no effect on blood glucose (5.53-5.59 mmol/L) or blood lipids (TG 1.47-1.55 mmol/L, TC 5.04-5.17 mmol/L, LDL-C 3.00-3.07 mmol/L, and VLDL 0.73-0.76 mmol/L) in patients 1-6 months after renal transplantation. Conclusion FK506 does not affect the level of glycolipid metabolism in patients after renal transplantation. Cys C is positively related to blood concentration of FK506 in the renal transplantation recipients. The rational use of FK506 can improve the effectiveness and safety of the treatment in the recipients.