环孢素（CsA）微乳剂是多年以来肾移植受者免疫抑制剂的中坚力量。但是每天单剂量（SD）环孢素的方法却很少使用。该研究的目的在于比较SD和每天两剂的环孢素使用方法的效果。回顾性分析44名使用SD的肾移植患者共12个月（研究组）。选取相同数量的在年龄、性别、HLA错配、供体类型及免疫抑制方案匹配的患者（对照组）。我们评估了CsA的血谷浓度（C0）和峰浓度（C2），12小时CsA形态以及达峰时间的曲线下面积（AUC）。在转换为SD后，C0、C2和累积AUC显著不同。在研究组，平均AUC之前为4619 ng/mL/h，而转换为SD后AUC为6567 ng/mL/h（P=0.004）可能对于对照组来说，平均AUC更有意义。治疗组的每天总CsA剂量明显低于对照组（P < 0.0001）。在研究组，肝炎发生率明显较高（P = 0.011）。在研究组，不良反应明显低于对照组。两组间移植物及患者的治疗结果无明显差异。我们总结认为，肾移植患者CsA剂量应该个体化，尤其是合并病毒性肝炎时。SD对于维持移植物良好功能并降低CsA剂量、减少CsA相关不良反应有益。

Cyclosporine (CsA) microemulsion has been the mainstay immunosuppressive agent for renal transplant recipients for years. A single daily dosing of cyclosporine (SD) is rarely used. The objective of this study was to evaluate the efficacy of SD versus twice daily dosing of CsA. Retrospective evaluation of SD use was conducted for 44 renal transplant recipients for 12 months (study group). Equal numbers of matched recipients were selected for age, sex, HLA mismatch, donor type, and immunosuppressive regimen (control group). We measured CsA trough (C0) and peak (C2) blood levels, 12-hour CsA profile, and the area under the concentration-time curve (AUC). There were significant differences in C0, C2, and calculated AUC after shifting to SD. In the study group, the mean AUC was 4619 ng/mL/h before versus after shifting to SD (P = .004). This became more therapeutic and identical to the mean AUC in the control group, which was 6551 ng/mL/h. Total daily CsA dose was significantly lower in the study group compared with the control group (P < .0001). A significantly higher incidence of hepatitis was observed among the study group (P = .011). There were significantly fewer adverse effects in patients in the study 6567 ng/mL/h group than the control group. There were no significant differences in graft and patient outcomes between the groups. We concluded that CsA dose should be individualized in renal transplant recipients especially if they have viral hepatitis. SD has the advantage of decreasing dosage and CsA-related adverse effects while maintaining optimal graft function.

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