k¶¹Ç®°ü

English

±ðÈá°ÓÃÒ©Ã¤Çø¡±ÉËÁËÒÆÖ²Éö£¡¡ª¡ªÃ¹·ÓËá¼ì²âÊÔ¼ÁºÐ£¬ÊØ»¤ÄãµÄÊõºó½¡È«£¡

°ä²¼ÓÚ£º2025-12-26

ÎÄÕÂÆðÔ´£º[ÖÐÎÄ]k¶¹Ç®°üÉúÎï



Êý¾ÝÏÔʾ£ºÄ¿Ç°£¬ÎÒ¹úÓÐÉöÔàÒÆÖ²Ò½ÁÆ»ú¹¹149¼Ò£¬ÀÛ¼ÆÊµÏÖ¶ùͯÉöÔàÒÆÖ²4000ÓàÀý[1]¡£´ÓÊõºóÉú¼ÆÂÊÀ´¿´£¬Ö»¹ÜÎÒ¹úÉöÔàÒÆÖ²¼¼ÊõÒÑ´ï¹ú¼ÊÏȽøË®Æ½£¬1ÄêÒÆÖ²Éö´æ»îÂʿɴﵽ95%ÒÔÉÏ£¬µ«Ëæ×ÅÊõºó¹¦·òÍÆÒÆ£¬´æ»îÂÊÈÔ»áÎî¶ÔÌôÕ½£¬5Äê´æ»îÂʽµÖÁ70%-80%£¬¶øµ¼Ö´æ»îÂʽµÂäµÄÖ÷ÌâÔ­ÒòÖ®Ò»£¬¾ÍÊÇÊõºóÇãÔþ·´Ó³ÓëÃâÒßÒÖÔì¼Á²»Á¼·´Ó³µÄË«³ÁÍþв¡£


ÈôºÎÔÚ¡°ÓÐЧԤ·ÀÇãÔþ·´Ó³¡±Óë¡°½µµÍÒ©Îï²»Á¼·´Ó³¡±Ö®¼äÕÒµ½Æ½ºâ£¬³ÉΪÉöÔàÒÆÖ²ÊõºóÒ½ÖεÄÖ÷ÌâÄÑÌâ¡£¶ø½â¾öÕâÒ»ÄÑÌâµÄ¹Ø¼ü£¬¾ÍÔÚÓÚ¶ÔÃâÒßÒÖÔì¼ÁµÄѪҩŨ¶È½øÐо«×¼¼à²â¡ª¡ªÖ»ÓÐÈÃÒ©ÎïŨ¶ÈʼÖÕά³ÖÔÚ¡°Ò½Öδ°¡±ÄÚ£¬ÄÜÁ¦¼È²ûÑÇãÔþ×÷Óã¬ÓÖ×î´óÏÞ¶ÈÏ÷¼õ²»Á¼·´Ó³¡£¶øÃ¹·ÓËá(mycophenolic acid£¬MPA)ÀàÒ©ÎïÊÇ»ù´¡ÃâÒßÒÖÔìµÄ³ÁÒª×é³É²¿ÃÅ£¬ÊǸΡ¢ÉöÒÆÖ²ÊÜÕßµÄ**ÃâÒßÒÖÔì»ù´¡Ò©ÎïÖ®Ò»[2]¡£ÔçÔÚ2009Ä꣬¸ÄÉÆÈ«ÇòÉö²¡Ô¤ºó×éÖ¯£¨KidneyDisease: Improving Global Outcomes£¬KDIGO£©ÒÑÍÆ¼ö½« MPA ÀàÒ©Îï×÷ΪһÏß¿¹ÔöÖ³ÀàÒ©ÎïÓÃÓÚÉöÒÆÖ²ÊÜÕß³õʼºÍά³ÖÃâÒßÒÖÔìÒ½ÖΣ¬ÓÃÓÚ½µµÍ¼±ÐÔÇãÔþ·´Ó³(acute rejection£¬AR)²úÉú·çÏպ͵¢¸éÒÆÖ²ÎïÓëÊÜÕßµÄÉú¼ÆÆÚ[3]¡£

1

MPAÓ°Ïì³É·Ö


µ«ÓÉÓÚù·ÓËá·ÖÆç¸ö±ðÖ®¼äMPAÒ©´ú¶¯Á¦Ñ§£¨PK£©²î¾à¿É´ï10±¶£¬ÆäŨ¶È¶³ö¿ÉÄÜÊÜ»¼Õß´ºÇï¡¢ÖÖ×å¡¢²¡ÉúÀí״̬¼°¹é²¢ÓÃÒ©µÈ¶à³Á³É·Ö×ÛºÏÓ°Ïì[4]£¬´«Í³¸øÒ©·½Ê½ÎÞ·¨Âú×ãÁÙ´²ÐèÒª¡£Òò¶ø£¬¶ÔÉöÔàÒÆÖ²Êõºó»¼ÕßµÄù·ÓËáѪҩŨ¶È½øÐÐʵʱ¡¢¾«×¼¡¢±ã½ÝµÄ¼ì²â£¬ÒѳÉΪÁÙ´²ÕïÁÆÖв»³É»òȱµÄ¹Ø¼ü»·½Ú£¬¶øÕâÒ²ÕýÊÇÎÒÃǽñÌìÒª³Áµã½éÉܵġª¡ªÃ¹·ÓËá¼ì²âÊÔ¼ÁºÐµÄÖ÷Ìâ¼ÛÖµµØµã¡£




¼à²â½¨Òé


½¨ÒéÒÆÖ²Êõºó2ÖÜÄÚ£¬Ã¿Öܼà²â2´Î£¬Ö±ÖÁ´ïµ½Ö¸±êŨ¶È£»Í¨³£Çé¿öÏÂÊõºó3-4ÖÜ£¬Ã¿ÖÜ1-2´Î£»Êõºó1-3ÔÂÿÖÜ1´Î£»Êõºó4-12¸öÔÂÿ3-4ÖÜ1´Î£»Êõºó1ÄêÒÔÉÏÿ1-2ÔÂ1´Î£¬Êõºó5ÄêÒÔÉÏÖÁÉÙÿ¸ö¼¾¶È¼à²â1´Î¡£

¡ª¡ªÖйúÉöÔàÒÆÖ²ÊÜÕßÃâÒßÒÖÔìÒ½ÖÎÖ¸ÄÏ£¨2023°æ£©[5]


  • ½¨ÒéÉöÒÆÖ²ÊÜÕßÓÐǰÌáʱӦ½øÐÐMPAÀàÒ©ÎïµÄTDM¡£ÉöÒÆÖ²ÊÜÕßÊõºó1ÖÜʱӦ½øÐÐ1´ÎTDM£¬µ÷Õû¼ÁÁ¿ºóÔÙ¼ì²â1´Î£¬µ±ÑªÒ©Å¨¶È²»±äºó1ÄêÄÚ¿É×ÃÇé¼ì²â1-2 ´Î¡£

  • ĿǰÓÐÏÞ²ÉÑù·¨ÊÇÁÙ´²¿ÉÐÐÐԽϸߵÄMPA-AUC ¼à²â²½Öè¡£½¨ÒéѡȡÊʺÏÖйúÈËȺµÄ¡¢¾­¹ýÖйúÈËȺÑéÖ¤µÄ MPA-AUC ¼ò»¯ÍÆË㹫ʽ¡£·þÓà MMFµÄÒÆÖ²ÊÜÕßÄܹ»Ê¹Óþ­¹ýÖйúÈËȺÑéÖ¤µÄ¡°Èýµã·¨¡±£Û·þҩǰ30min£¨C0£©¡¢·þÒ©ºó0.5h£¨C0.5£©ºÍ·þÒ©ºó2h£¨C2£©£Ý¹«Ê½¡£

¡ª¡ª¡ªÖйú¸Î¡¢ÉöÒÆÖ²ÊÜÕßù·ÓËáÀàÒ©ÎïÀûÓÃר¼Ò¹²Ê¶(2023°æ)[6]


´«Í³¼ì²â²½Ö裨Èç¸ßЧҺÏàÉ«Æ×·¨£©²Ù×÷¸´ÔÓ¡¢¼ì²âÖÜÆÚ³¤£¨Í¨³£±ØÒªÊýÓ×ʱÖÁ1Ì죩¡¢¶Ô³¢ÊÔÊÒÉ豸ºÍ²Ù×÷ÈËÔ±ÒªÇó¸ß¡¢³É±¾½Ï¸ß£¬ÄÑÒÔÂú×ãÁÙ´²¼±¾ç¡¢±ã½Ý¡¢¾«×¼¼ì²âµÄÐèÒª¡£½ð˹¶ûIMPDH ¢òø·¨MPAÊÔ¼Á£¬»úÄÜÓë½ø¿ÚÆ·ÅÆÊÔ¼ÁÏ൱£¬²âÖµÓйØÐÔR2£¾0.99£¬¿ÉÂú×ãÁÙ´²¼ì²âÐèÒª¡£




½ð˹¶ûù·ÓËá¼ì²âÊÔ¼ÁºÐ¾«ÃܶÈÓÅÁ¼£¬CV£¼5%

2




Óë½ø¿ÚÖ÷Á÷ÊÔ¼Á²âÖµÓйØÐԺã¬R2£¾0.99

3


ÉöÒÆÖ²Êõºó£¬Ã¹·ÓËá×÷Ϊ±£»¤ÒÆÖ²ÉöµÄ¹Ø¼üÒ©Î¶ÔÔ¤·ÀÇãÔþ·´Ó³ÓµÓгÁÒª×÷Óá£Èô²»×ãÓÐЧµÄ¼à²â£¬²»½ö¿ÉÄÜÒòÒ©ÎïŨ¶È²»¼°Ê¹ÒÆÖ²ÉöÃæ¶ÔÇãÔþ·çÏÕ£¬»¹¿ÉÄÜÒòŨ¶È¹ý¸ßÒý·¢Éí¶Î²»ÊÊ£¬½ø¶øÓ°ÏìÊõºó¸´Ô­¹ý³Ì¡£k¶¹Ç®°üÐÂÍÆ³öµÄù·ÓËá¼ì²âÊÔ¼ÁºÐ²Ù×÷Çá±ã¡¢¼ì²âÖÜÆÚ¶Ì£¬ºÏÓÃÓÚ»ù²ãÒ½ÁÆ»ú¹¹£¬¿ÉÄÜʵÏÖʵʱ¡¢¾«×¼µÄ¼à²â£¬ÖúÁ¦Ê¹ÓÃÕß°Ñ¿ØÓÃÒ©°²È«£¬¶ã±ÜÒò¼à²â²»ÊµÊ±»ò²»ÕýÈ·´øÀ´µÄ½¡È«Òþ»¼£¬ÇÐʵ±£ÏÕÒÆÖ²Éö½¡È«¡£



4


²Î¿¼Îļþ

[1] ÖлªÈËÃñ¹²ºÍ¹ú˾·¨²¿.Ç¿»¯ÖÎÀí Æô·¢´´ÐÂ ÍÆ¶¯Æ÷¹ÙÒÆÖ²¼¼ÊõÄÜÁ¦Ë®Æ½³ÖÐøÌáÉý[EB/OL]. (2025-09-17)(2023-12-14) https://www.moj.gov.cn/pub/sfbgw/fzgz/fzgzxzlf/fzgzlfgz/202312/t20231214_491545.html?CTPIC=824090?

[2] ÖлªÒ½Ñ§»áÆ÷¹ÙÒÆÖ²Ñ§·Ö»á.Æ÷¹ÙÒÆÖ²ÃâÒßÒÖÔì¼ÁÁÙ´²ÀûÓü¼Êõ¹æ·¶(2019 °æ)[J].Æ÷¹ÙÒÆÖ²,2019,10(3):213-226.

[3] Kidney Disease:Improving Global Outcomes(KDIGO) Transplant Work Group. KDIGO clinical practice guideline forthe care of kidney transplant recipients[J]. Am J Transplant,2009,9(Suppl 3):S1-S155.

[4] Áõˬ,ÕŶ÷Ñþ,Ò×Õ¿Ãç, µÈ.Öйúù·ÓËáÒ½ÖÎÒ©Îï¼à²âµÄ½ü¿ö·ÖÎö[J].ÖйúÁÙ´²Ò©ÀíѧÔÓÖ¾,2021,37(3):308-311.

[5] ÖлªÒ½Ñ§»áÆ÷¹ÙÒÆÖ²Ñ§·Ö»á,ÖйúÒ½ÁƱ£½¡¹ú¼Ê»¥»»Íƽø»áÉöÔàÒÆÖ²Ñ§·Ö»á.ÖйúÉöÔàÒÆÖ²ÊÜÕßÃâÒßÒÖÔìÒ½ÖÎÖ¸ÄÏ(2023°æ)[J].ÖлªÆ÷¹ÙÒÆÖ²ÔÓÖ¾, 2024, 45(10):645-663.

[6] ÖлªÒ½Ñ§»áÆ÷¹ÙÒÆÖ²Ñ§·Ö»á,ÖйúҽʦЭ»áÆ÷¹ÙÒÆÖ²Ò½Ê¦·Ö»á,ÉϺ£Ò½Ò©ÐÐҵЭ»á,µÈ. Öйú¸Î¡¢ÉöÒÆÖ²ÊÜÕßù·ÓËáÀàÒ©ÎïÀûÓÃר¼Ò¹²Ê¶(2023°æ)[J]. ÉϺ£Ò½Ò©,2023,44(10):577-595.

¸ßµÍ»¬¶¯²é¿´ÆëÈ«²Î¿¼Îļþ



END

ÎÄÕÂÆðÔ´£ºk¶¹Ç®°üÉúÎï

Ôð±à£ºEcho

У¶Ô£ºCassie¡¢Miss Bio



 
¡¾ÍøÕ¾µØÍ¼¡¿