摘要
目的 研究他克莫司 (FK5 0 6 )在同种肾移植术后抗排斥反应的效果及毒副作用。方法 136例肾移植患者在术后 2 4h开始服用FK5 0 6 ,起始量 0 .15mg·kg-1·d-1,同时口服霉酚酸酯(MMF) 1.0 g/d、泼尼松 (Pred) 30mg/d。观察FK5 0 6的治疗效果、理想的治疗窗及毒副反应。 结果 肾移植术后 136例应用FK5 0 6的患者中 ,肾功能 2～ 7d恢复正常为 96例 ,8～ 15d恢复正常为 2 3例 ,16～ 2 0d恢复正常为 14例 ,肾功能未恢复正常仅有 3例。观察期间 ,发生急性排斥反应 (AR) 17例 (12 .5 % ) ,糖代射紊乱 2 5例 (18.4% ) ,神经系统功能紊乱 3例 (2 .2 % ) ,肝功能异常 5例 (3 .7% ) ,肾中毒 4例 (2 .9% ) ,消化功能紊乱 31例 (2 2 .8% ) ,巨细胞病毒感染 5例 (3.7% ) ,肺部感染 3例(2 .2 % )。因脑出血死亡 1例 ,移植肾功能丧失、摘除移植肾 2例。FK5 0 6血药浓度为 5～ 2 0 μg/L。结论 肾移植术后应用FK5 0 6是安全有效的 ,排斥反应发生率明显降低 ,副作用小。但FK5 0 6所致的糖代谢紊乱应引起注意 ,其对人 /肾长期存活的影响还需进一步观察。
Objective To study the effects and side effects of tacrolimus (FK506) in the prevention of renal allograft rejection. Methods 136 patients undergoing renal transplantion orally administered FK506 with the initial dose of 0.15 ?mg/kg daily, mycophenolate mofetil ( 1.0 ?g/d) and meticorten (Pred, 30?mg/d) 24?h after transplantation. The curative effects, therapy index and side effects were observed. Results In 136 patients using FK506 after renal transplantation the incidence of acute rejection (AR) was 12.5 ?% ( n =17), glycometabolism disorder was 18.4 ?%( n =15), nervous system disturbance was 2.2 ?%( n =3), abnormal liver function was 3.7 ( n =5), nephrotoxicity was 2.9 ?% ( n =4), disorders of digestion was 22.8 ?%( n =31), cytomegalovirus (CMV) infection was 3.7 ?%( n =5), pulmonary infection was 2.2 ?%( n =3). One died from cerebral hemorrhage but the allograft function was normal and two were removed the allograft because of the function loss. All the blood concentrations of FK506 were 5 to 20?μg/L. Conclusions FK506 could decrease the incidence of rejection in kidney transplant recipients with little side effects and toxicity. So it was a safe and effective immunosuppressive agent, particularly in patients who experienced cyclosporine nephrotoxicity. However, glycometabolism disorder caused by FK506 should be paid attention.
出处
《中华器官移植杂志》
CAS
CSCD
2000年第6期359-360,共2页
Chinese Journal of Organ Transplantation
