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目的:观察腹泻对肾移植受者他克莫司谷浓度的影响,并探讨其发生的可能原因和机制。方法:观察了肾移植术后出现腹泻的患者27例,在他克莫司和环孢素治疗组中分别有20例和7例。观察了围腹泻期药物剂量及谷浓度变化,并进行了与腹泻相关病原学检查。结果:在腹泻期间分别有15例(75%)和2例(28.6%)患者他克莫司和环孢素谷浓度明显升高。通过抗感染、减低霉酚酸酯剂量及止泻等综合治疗,腹泻治愈,他克莫司谷浓度在腹泻愈后3～17 d内下降至治疗范围。结论:腹泻是引起他克莫司谷浓度升高的重要因素。腹泻期间应适当减低他克莫司剂量和密切监测他克莫司谷浓度变化。
Objective: To observe the effect of diarrhea on the concentration of tacrolimus in renal transplant recipients and to explore its possible causes and mechanisms. Methods: Twenty-seven patients with diarrhea after renal transplantation were observed. Tacrolimus and cyclosporine treatment groups were 20 and 7, respectively. Perioperative diarrhea drug dose and trough concentration were observed, and diarrhea-related etiological examination was performed. RESULTS: Tacrolimus and cyclosporine concentrations were significantly elevated in 15 (75%) and 2 (28.6%) patients during diarrhea, respectively. Through anti-infection, reduce mycophenolate mofetil dose and diarrhea and other comprehensive treatment, diarrhea cure, tacrolimus Valley diarrhea healing within 3 ~ 17 d reduced to the treatment range. Conclusion: Diarrhea is an important factor in the increase of tacrolimus concentration. During diarrhea, the dose of tacrolimus should be appropriately reduced and the concentration of tacrolimus should be closely monitored.