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肾移植术后应用咪唑立宾抗排斥治疗的临床观察

Mizoribine: An effective and low-toxic immunosuppressant for renal transplantation patients

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【作者】 陈劲松; 季曙明; 沙国柱; 程震; 孙启全; 文吉秋; 程东瑞; 刘志红; 黎磊石;

【Author】 CHEN Jing-song,JI Shu-ming,SHA Guo-zhu,CHENG Zhen,SUN Qi-quan,WEN Ji-qiu,CHENG Dong-rui,LIU Zhi-hong,LI Lei-shi(PLA Research Institute of Nephrology,Nanjing General Hospital of Nanjing Military Command,PLA,Nanjing 210002,Jiangsu,China)

【机构】 南京军区南京总医院解放军肾脏病研究所;

【摘要】 目的:探讨咪唑立宾(MZR)在肾移植术后抗排斥治疗临床的效果及安全性。方法:38例首次接受肾移植的患者采用环孢素(CsA)或他克莫司(FK506)+MZR+泼尼松(Pred)治疗,与同期31例采用CsA或FK506+霉酚酸酯(MMF)+Pred治疗的患者进行比较。观察2组患者在肾移植术后12月内的人、肾存活率及肾功能变化情况,比较2组间急性排斥反应、药物不良反应(外周血白细胞下降、肝功能异常、血尿酸升高及胃肠道症状)以及肺部感染的发生率。结果:随访12个月,MMF组患者人、肾存活率均为100%,MZR组人、肾存活率分别为100%、97.4%。肾移植术后MMF组和MZR组急性排斥反应的发生率相似,2组在肾移植术后1、2、3月的血肌酐差异无统计学意义,在6月和12月MZR组血肌酐较MMF组明显增高(P<0.05);与MMF组相比,MZR组患者的胃肠道症状、肺部感染发生率明显下降(P<0.05),而外周血白细胞下降、高尿酸血症以及肝功能异常等方面的发生率差异无统计学意义。结论:在肾移植中应用MZR安全、不良反应小,可以作为肾移植患者术后常规的免疫抑制剂。

【Abstract】 Objective: To investigate the effect and safety of Mizoribine(MZR) in allograft kidney transplantation. Methods: Thirty-eight recipients of first allograft kidney transplantation received Pred+CsA or FK506+MZR while the other 31 Pred+CsA or FK506 + MMF.Comparisons were made between the two groups in the patient/kidney survival rate,SCr,incidence of acute rejection,drug toxicity/side effects(leucopenia,GPT above normal,hyperuricemia and gastrointestinal symptom) and pulmonary infection.Results: No significant differences were observed in the patient/kidney survival rate,acute rejection incidence and SCr between the two groups 1,2 and 3 months after the transplantation.Compared with the MMF group,SCr was significantly increased at 6 and 12 months(P<0.05),while the incidences of gastrointestinal symptoms and pulmonary infection markedly decreased in the MZR group(P<0.05).No statistic differences were shown in the incidences of leucopenia,GPT above normal and hyperuricemia between the two groups. Conclusion: MZR,with its high safety and low toxicity/side effects,can be used as a maintenance immunosuppressant after allograft kidney transplantation.

【关键词】 肾移植; 免疫抑制剂; 咪唑立宾;
【Key words】 Renal transplantation; Mizoribine; Immunosuppressant;
  • 【文献出处】 医学研究生学报 ,Journal of Medical Postgraduates , 编辑部邮箱 ,2009年01期
  • 【分类号】R699.2
  • 【被引频次】11
  • 【下载频次】203
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