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目的 研究环孢素A (CsA)血药浓度变异系数 (CV)的临床意义。方法 185例尸肾移植受者 ,其中口服CsA微乳剂 (CsA ME)组 92例 (排斥反应 15例 ) ,口服CsA普通胶囊 (CsA GC)组93例 (排斥反应 2 1例 )。比较CsA ME组与CsA GC组CsA血药浓度变异系数的差异及排斥组与非排斥组CsA血药浓度变异系数的差异。结果 CsA ME组血药浓度变异系数小于CsA GC组 (P <0 .0 5 )。排斥反应组CsA血药浓度变异系数高于非排斥组的变异系数 (P <0 .0 5 )。结论 口服CsA ME血药浓度更稳定。排斥反应的发生与CsA血药浓度不稳定有关。CsA血药浓度变异系数是反映个体对CsA生物利用度变化大小的较可靠的指标 ,可以指导临床血药浓度的监测频度。
Objective To study the clinical significance of CsA concentration variation coefficient (CV). Methods A total of 185 renal transplant recipients were enrolled. Among them, 92 were treated with CsA ME (15 cases) and 93 cases were treated with CsA GC (21 cases with rejection). The differences of the coefficient of variation of CsA concentration in CsA ME group and CsA GC group and the coefficient of variation of CsA concentration in rejection group and non-rejection group were compared. Results The coefficient of variation of plasma concentration of CsA ME group was less than that of CsA GC group (P <0.05). The coefficient of variation of CsA concentration in rejection group was higher than that in non-rejection group (P <0.05). Conclusion Oral CsA ME plasma concentration is more stable. Rejection occurred with the CsA plasma concentration instability. The coefficient of variation of CsA blood concentration is a reliable indicator to reflect the change of individual bioavailability of CsA, which can guide the monitoring of clinical blood drug concentration.