摘要
目的:比较肾移植术后早期应用咪唑立宾(商品名:布累迪宁)与常用免疫抑制剂吗替麦考酚酯的差异,为咪唑立宾的临床应用提供参考。方法:选择2004-01/2006-08在西安高新医院肾移植中心住院的肾移植术后患者112例,均知情同意。根据术后应用免疫抑制剂不同按随机数字表法分为两组:①吗替麦考酚酯组60例,使用吗替麦考酚酯(商品名:骁悉)1.5g/d+环孢素A2.5-4.5mg/d+泼尼松10-20mg/d。②咪唑立宾组52例,使用咪唑立宾(商品名:布累迪宁,日本旭化成株式会社研制)200mg/d+环孢素A2.5-4.5mg/d+泼尼松10-20mg/d。治疗过程中,监测是否出现急性排异反应,以及两种免疫抑制剂对肝功能、骨髓以及消化系统功能的影响。结果:肾移植术后患者112例全部进入结果分析,无脱落。①两组患者术后1个月内急性排异反应的发生率比较:吗替麦考酚酯组及咪唑立宾组差异无显著性意义(5.5%,5.8%,P>0.05)。②两组患者术后1个月的血常规、消化系统反应发生情况比较:吗替麦考酚酯组患者的白细胞降低(<4×1012)发生率显著高于咪唑立宾组(26.7%,0,P<0.05);吗替麦考酚酯组患者的消化系统反应发生率显著高于咪唑立宾组(18.3%,0,P<0.05)。③两组患者术后1个月的肝功能比较:吗替麦考酚酯组患者的谷丙转氨酶升高发生率显著低于咪唑立宾组(13.3%,34.6%,P<0.05);吗替麦考酚酯组患者的谷草转氨酶升高显著低于咪唑立宾组(10.0%,32.7%,P<0.05)。④两组患者术后1个月的不良反应发生情况比较:咪唑立宾组患者的血尿酸水平升高发生率高于替麦考酚酯组(50.0%,31.6%,P<0.05)。结论:肾移植术后早期应用咪唑立宾很少出现骨髓抑制、胃肠道反应等副作用,在术后早期排异发生率方面,与吗替麦考酚酯也没有明显差异。相对而言,咪唑立宾维持剂量小,费用较低。但是要注意到咪唑立宾对肝功能方面的损害及增加血尿酸水平的可能。
AIM： To compare the efficacy difference between Mizoribine （trade name： Bredinin） and Mycophenolate, a commonly used immunodepressive, in the early period after renal transplantation, and to provide data for clinical application of Mizodbine.
METHODS： Totally 112 inpatients with renal transplantation in the Renal Transplantation Center of Xi＇an Hi-tech Hospital were registered from January 2004 to August 2006. Written informed consent was obtained for the study from each patient. According to the different immunosuppressive drugs used in the early period after renal transplantation, the patients were classified randomly into two groups： （1） Mycophenolate group （n =60）： the patients were administered with Mycophenolate （trade name：CellCept） of 1.5 g/d plus Cyclosporine A of 2.5-4.5 mg/d plus dehydrocortisone of 10- 20 mg/d. （2）Mizoribine group （n =52）： the patients were administered by combining Mizoribine （trade name：Bredinin, produced by Japanese Xuhuacheng Association） of 200 mg/d plus Cyclosporine A of 2.5-4.5 mg/d plus dehydrocortisone of 10-20 mg/d. Acute rejection reaction and the side effects of two immunosuppressive drugs such as hepatic function, Myelosuppression and gastrointestinal reaction were monitored in the test.
RESULTS： The 112 patients with renal transplantation were involved in the result analysis, no drop-out. （1）rejection rate of the two groups one month after operation： There was no significant difference in the rejection rate compared Mycophenolate group with Mizoribine group （5.5%,5.8%, P 〉 0.05）. （2）blood test and gastrointestinal reaction of the two groups one month after operation： The leukocytopenia（〈 4× 10^12） rate of Mycephenolate group was significantly higher as compared with Mizoribine group （26.7% ,0,P 〈 0.05）. The gastrointestinal reaction in the Mycophenolate. group was significantly higher than it in Mizoribine group （18.3% ,0,P 〈 0.05）. （3） liver function of the two groups one month after operation： The abnormal high glutamic-pyruvic transaminase in the Mycophenolate group was significantly lower as compared with Mizoribine group （13.3% ,34.6%, P 〈 0.05）. The abnormal high level of glutamic oxaloacetic transaminase in the Mycophenolate group was significantly lower than it in the mizoribine group （10.0%,32.7%,P 〈 0.05）. （4）side effects of the two groups one month after operation： The uricemia in the Mizoribine group was significantly higher as compared with Mycophenolate group （50.0% ,31.6%, P 〈 0.05）.
CONCLUSION： Mizoribine seldom has the side effects such as Myelosuppression and gastrointestinal reaction when used in the early period after renal transplantation. Mizoribine offers no significant advantage over Mycophenolate for the early rejection. Relatively speaking, Mizoribine is cheaper and lower in dosage than Mycophenolate. It is noticed that Mizoribine may damage the liver function and cause uricemia.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第16期3134-3135,共2页
Journal of Clinical Rehabilitative Tissue Engineering Research
