2025 年第 9 期 第 20 卷

环孢素浓度对再生障碍性贫血患者糖脂和尿酸代谢以及肾功能的影响

Effect of cyclosporine concentration on glucolipid and uric acid metabolism and renal function in patients with aplastic anemia

作者：谷宏伟鲁静海鑫

英文作者：Gu Hongwei Lu Jing Hai Xin

单位：哈尔滨医科大学附属第一医院药学部，哈尔滨150000

英文单位：Department of Pharmacy the First Affiliated Hospital of Harbin Medical University， Harbin 150000 China

关键词：再生障碍性贫血；环孢素；血药浓度；糖脂代谢；尿酸代谢；肾功能

英文关键词：Aplasticanemia;Cyclosporin;Bloodconcentration;Glucolipidmetabolism；Uricacidmetabolism;Renalfunction

• 摘要：

• 目的 探讨不同环孢素浓度对再生障碍性贫血患者血糖、血脂、血尿酸等代谢以及肾功能的影响。方法 选取2021年1月至2024年1月哈尔滨医科大学附属第一医院接受环孢素治疗的再生障碍性贫血患者143例，按血药浓度监测时间的不同分为用药后1个月组（A组，31例）、用药后3个月组（B组，34例）、用药后6个月组（C组，42例）和用药后12个月组（D组，36例）。收集不同组患者环孢素血药浓度、血糖、血脂、血肌酐以及血尿酸等指标，并分析环孢素血药浓度与各指标的相关性。结果 A、B、C、D组患者的环孢素血药浓度分别为(193±28)、(214±19)、(188±28)、(176±26)μg/L，B组血药浓度均高于A、C、D组(均P＜0.05)。4组患者的血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和肌酐水平比较差异均有统计学意义(均P＜0.05)，血尿酸水平差异无统计学意义（P＞0.05）。相关性分析结果显示，血糖、甘油三酯、低密度脂蛋白胆固醇以及血肌酐与环孢素血药浓度均呈正相关，高密度脂蛋白胆固醇与环孢素血药浓度呈负相关（均P＜0.05)，而总胆固醇和血尿酸水平与环孢素血药浓度无相关性（均P＞0.05）。结论 环孢素血药浓度对再生障碍性贫血患者血糖、血脂代谢以及肾功能有影响，对血尿酸代谢无影响。

• Objective To investigate the effects of different concentrations of cyclosporine on metabolism of blood glucose, blood lipid, uric acid, etc and renal function in patients with aplastic anemia. Methods A total of 143 patients with aplastic anemia treated with cyclosporine in the First Affiliated Hospital of Harbin Medical University from January 2021 to January 2024 were selected. According to the different blood drug concentration monitoring time, they were divided into 1 month after treatment group (group A, 31 cases), 3 months after treatment group (group B, 34 cases) and 6 months after treatment group (group C, 42 cases) and 12 months after treatment group (group D, 36 cases). The blood concentration of cyclosporine, blood glucose, blood lipid, serum creatinine and uric acid of patients in different groups were collected, and the correlation between the blood concentration of cyclosporine and each index was analyzed. Results The blood concentrations of cyclosporine in groups A, B, C, and D were (193±28), (214±19), (188±28), and (176±26)μg/L, respectively. The blood concentration of cyclosporine in group B was higher than those in groups A, C, and D(P＜0.05). There were statistically significant differences in the levels of blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and creatinine among the four groups (all P<0.05), and there was no statistically significant difference in the level of uric acid (P>0.05). The results  of correlation analysis showed that blood glucose, triglyceride, low-density lipoprotein cholesterol and creatinine were positively correlated with the blood concentration of cyclosporine, high-density lipoprotein cholesterol was negatively correlated with the blood concentration of cyclosporine(all P＜0.05), while total cholesterol and uric acid levels were not correlated with the blood concentration of cyclosporine(both P＞0.05). Conclusions The plasma concentration of cyclosporine has an effect on blood glucose, lipid metabolism and renal function in patients with aplastic anemia, but has no effect on uric acid metabolism.