摘要
目的探讨肾移植术后用药导致他克莫司(FK506)血药浓度过高引起高钾血症的处理方法。方法对肾移植术后服用抗真菌药物致FK506血药浓度过高而引起的高钾血症10例患者的临床资料进行归纳和分析。结果 10例患者术后1~2个月内出现肺部感染或肺炎合并肺部真菌感染等,对症选用相应剂量的复方磺胺甲唑、米卡芬净、头孢哌酮钠-舒巴坦钠和莫西沙星等药物进行抗真菌感染治疗。经过降钾治疗及停用抗真菌药物、调整FK506剂量(部分病例更换为环孢素)后,10例患者血钾下降并维持在正常范围,同时FK506血药浓度也在正常范围,之后未采取任何降血钾措施,未再发生高血钾现象。结论肾移植术后用药易导致FK506血药浓度过高,引起高钾血症,治疗上应采用降钾、停用相关药物、调整免疫抑制剂,避免产生有害的相互作用。
Objective To investigate the therapeutic methods of hyperpotassemia induced by excessively high blood concentration of tacrolimus （FKS06） caused by drug use after renal transplantation. Methods Clinical data of lO patients diagnosed with hyperpotassemia induced by excessively high blood concentration of FKS06 after administration of antifungal medication following renal transplantation were collected and retrospectively analyzed. Results At 1-2 months after renal transplantation, 10 patients suffered from pulmonary infection or pneumonia complicated with pulmonary fungal infection. An appropriate dose of compound sulfamethoxazole, micafungin, cefoperazone sodium-sulbactam sodium and moxifloxacin was administered for antifungal infection. After potassium-lowering therapy, termination of antifungal medication and FK506 dose adjustment （replaced by cyclosporin for certain cases）, the serum level of potassium was dechned and maintained within normal range for 10 cases. The serum concentration of FK506 was within normal range. No sign of excessively high level of potassium was observed without any potassium-lowering intervention. Conclusions Postoperative administration of drugs is likely to cause excessively high level of FK506 and hyperpotassemia. Potassium-lowering therapy, termination of drug use and adjustment of immunosuppressive agents should be adopted to avoid the incidence of adverse pharmacologic interaction.
作者
邱春燕
隋雨荧
于立新
邓文锋
苗芸
刘如敏
叶桂荣
Qiu Chunyan Sui Yuying Yu Lixin Deng Wenfeng Miao Yun Liu Rumin Ye Guirong(Eight-year MD-PhD Program, Southern Medical University, Guangzhou 510515, China)
出处
《器官移植》
CAS
CSCD
2017年第1期40-43,共4页
Organ Transplantation
基金
国家自然科学基金(81500573)
南方医科大学南方医院院长基金(2013B011)
南方医科大学南方医院院级教育课题(14NJ-ZL01)
关键词
他克莫司
相互作用
高钾血症
术后
肾移植
临床研究
Tacrolimus
Interaction
Hyperpotassemia
Postoperative, Renal transplantation
Clinical trial
