【摘要】 目的探讨低剂量环孢素A(CsA)在心脏移植中应用的安全性和有效性。方法57例同种异体心脏移植术术后予以不同的免疫抑制方案:第1组予传统三联方案—CsA+霉酚酸酯(MMF)+强的松(Pred)治疗;第2组术前予人源化单克隆抗白细胞介素-2受体抗体+/抗淋巴细胞球蛋白(ALG)/抗胸腺细胞球蛋白诱导,续接他克莫司(FK506)+MMF+Pred;第3组术前Daclizumab诱导,术后1～3d甲基强的松龙过渡,术后第4天接续CsA+MMF(2g/d)+Pred,CsA血药谷浓度控制在100～150ng/mL。结果术后肾功能损害、急性排斥及其他并发症第1组发生率最高,第2组明显减少,第3组最少;第3组与前2组比较差别均有统计学意义(P<0.05)。结论CsA在心脏移植术后免疫抑制治疗中的应用,充分显示其安全性、有效性和经济性。更多还原

【Abstract】 Objective To investigate the safety and efficacy of low-dose cyclosporine A in heart transplantation.Methods In our hospital,from Aug 1995 to Dec 2003,57 patients underwent heart allograft,fifty-six of which were standard style and one total style.The immunosuppression scheme exploited in group 1 was the classical triple-drug regime with CsA,Aza and Pred;Group 2 was given pre-operative induction therapy with Daclizumab,ALG or ATG followed by the triple-drug regime with FK506,MMF and Pred;group 3 was given pre-operative induction therapy with Daclizumab,while was followed by transition with methyl prednisolone and then the low-dose cyclosporine regime with CsA,MMF and Pred.The dose of MMF was 2 g/d.The blood trough concentration of CsA was 100~150 ng/mL.Results Nephritic damage,acute cardiac-allograft rejection and other complications were marked in group 1,while those were reduced in group 2 and minimum in group 3.The differences between group 1 and the other 2 groups were statistically significant(P<0.05).Conclusions Though the immunosuppressive therapy is relatively mature,the side effect of the immunosuppressant reduces the transplant effect.Adjustment of the regime is imperative in the situation.The low-dose cyclosporine A regime proves to be safe,effective and economical.更多还原