摘要
目的 比较肾移植后几种常用免疫抑制治疗方案的疗效与副作用。方法 根据所使用的免疫抑制治疗方案将 87例肾移植患者分为 4组 ,A组的免疫抑制治疗方案为他克莫司 (FK5 0 6 )、霉酚酸酯 (MMF)和泼尼松 (Pred) ;B组为环孢素A(CsA)、MMF和Pred ;C组为CsA、硫唑嘌呤 (Aza)和Pred ;D组为CsA和Pred。观察术后移植肾功能的恢复情况、排斥反应发生率、并发症及免疫抑制剂用量的变化。结果 A、B、C、D组移植肾 1年存活率分别为 10 0 %、96 .9%、85 .7%和 10 0 % ,急性排斥反应发生率分别为 0 %、15 .2 %、5 2 .4%和 5 2 .6 % ;A、B组的感染发生率高于C、D组 (P <0 .0 5 ) ,而C、D组术后初期一过性肝功能异常的发生率高于A、B组 ;移植后各组CsA用量逐渐减少 ,激素的用量也逐渐减少 ,但A组激素的调整幅度明显大于B、C、D组。结论 肾移植术后免疫稳态的建立是一个动态过程 ,鉴于个体差异性和免疫系统复杂性 ,不可能采用统一免疫抑制模式 ,应遵循选择性、协调性和特异性的用药原则。
Objectives To compare the therapeutic effects and side effects of four immunosuppression regimens for renal transplantation. Methods According to different drug combinations, 87 allograft recipients were divided into four groups: group A receiving FK506, MMF and Pred; group B receiving CsA, MMF and Pred; group C receiving CsA, Aza and Pred; group D receiving CsA and Pred. The recovery of renal function, survival rate, rejection episodes, complications and the changes in doses of immunosuppressive agents were observed. Results One-year survival rate in the groups A, B, C and D was 100*!%, 96.9 *!%, 85.7 *!% and 100*!% respectively. Rejection episodes in each group were 0 (group A), 5 (group B), 11 (group C) and 10 (group D). The infection rate in groups A and B was higher than in the groups C and D ( P < 0.05 ). The rate of transient liver function abnormality in groups C and D was higher than in groups A and B at the early stage after operation. CsA dosage in each group was gradually decreased and so did the dosage of hormone after operation. Conclusions Varied immunosuppression regimens should be selected due to differences in individuals and complexity of immune system.
出处
《中华器官移植杂志》
CAS
CSCD
2000年第5期285-287,共3页
Chinese Journal of Organ Transplantation
