摘要
背景:丙型肝炎病毒阳性患者接受肾脏移植后,免疫抑制剂的选择及抗丙型肝炎病毒药物的选用是目前关注的重点。目的:探讨环孢素在丙型肝炎病毒RNA阳性肾移植患者中除抗排斥作用以外的抗病毒复制作用。方法:纳入11例丙型肝炎病毒RNA阳性肾移植患者,于采用环孢素+咪唑立宾+泼尼松治疗方案时记为入组,分别对入组前、入组后6,12个月时患者丙型肝炎病毒RNA、血红蛋白、肝肾功能等指标的变化进行检测。结果与结论:入组前、入组6个月、入组12个月11例患者丙型肝炎病毒RNA中位数(copies/mL)分别为1.22×107,1.11×104,4.19×106;入组6个月时,有8例患者丙型肝炎病毒RNA转阴(丙型肝炎病毒RNA<500copies/mL),总应答率为73%(8/11);至随访结束,持续病毒学应答率为55%(6/11)。且入组治疗前后患者谷丙转氨酶、血清肌酐、血尿酸水平差异均无显著性意义(P>0.05),患者血红蛋白水平在入组后升高。随访过程中,仅1例发生排斥反应,甲基强的松龙冲击治疗3d后好转。提示对于合并丙型肝炎的肾移植患者,选用环孢素为主的治疗方案,在达到抗排斥治疗作用的同时,可发挥抑制丙型肝炎病毒复制的作用。
BACKGROUND： The selection of immunosuppressants and anti-hepatitis C virus drug is currently the focus for the hepatitis C virus-positive patients after receiving renal transplantation. OBJECTIVE： To investigate the anti-virus replication effect of cyclosporine in hepatitis C virus-RNA positive rena transplant recipients in addition to its anti-rejection effect. METHODS： Eleven hepatitis C virus-RNA positive renal transplant recipients were enrolled and treated with cyclosporine prednisone and mizoribine. Hepatitis C virus-RNA level, hemoglobin, liver functions and renal functions were evaluated before treatment and at 6 and 12 months after treatment. RESULTS AND CONCLUSION： The median of hepatitis C virus-RNA in 11 patients before treatment, and at 6 and 12 months after treatment were 1.22×107 copies/mL, 1.11×104 copies/mL and 4.19×106 copies/mL respectively. At 6 months after treatment, 8 cases of hepatitis C virus-RNA were negative （hepatitis C virus-RNA 〈 500 copies/mL）, and the total response of hepatitis C virus-RNA was 73%, and the sustained virological response was 55% （6/11 ） at the final follow-up There was no significant difference of alanine transaminase, serum creatinine and serum uric acid levels before and after treatment （P 〉 0.05）, and the hemoglobin level was increased after treatment. During the follow-up, acute rejection only occurred in one patient and was controlled within 3 days after methylprednisolone puise therapy. Cyclosporine-based treatment would be a better choice for renal transplant recipients combined with hepatitis C virus infection for both the anti-virus replication and anti-rejection effect.
出处
《中国组织工程研究》
CAS
CSCD
2012年第40期7426-7432,共7页
Chinese Journal of Tissue Engineering Research
