【摘要】 目的 观察肾移植木后环孢素向硫唑嘌呤转换的临床效果。方法 选择60例术后1年以上、肾功能稳定的肾移植受者进行免疫抑制剂从环孢素向唷唑嘌呤的转换。结果 60例病人平均血清肌酐在转换后1个月明显下降(148±58.5至132±86.9mmol/L,P<0.01),并在以后几年内继续下降,转换后6年时平均血清肌酐为112±39.8mmol/L。转换后平均血压也明显下降,并且抗高血压药物数量逐渐减少(P<0.01)。分别有9例(15％)和3例(6.7％)病人在转换后3个月内和3个月后发生急性排斥反应。转换后1年、5年人/肾存活率分别为95％/81.7％、86.7％/78.3％。5例(8.7％)病人因药物副作用和慢性排斥反应从硫唑嘌呤再转换为环孢素。结论 肾移植受者在术后一定时间将免疫抑制剂从环孢素转换为硫唑嘌呤是一种安全的免疫抑制方案,具有较好的移植肾长期存活。更多还原

【Abstract】 Objective to evaluate the clinical effect of conversion from cyclosporme(CsA) to azathioprine (AZA) after renal transplantation. Method 60 cadavecric renal allograft recipients with stabic kidney functiom were electively converted from cyelosporine to azathioprine more than one year after renal transplantation. Results The mean serum creatinine of 60 patients showcri a significant decrease in the first month after conversion (148+158. 5mmol/L to 132+ 86. 9mmol/L,p<0. 01) .and in following years the serum creatinine decreased further ro a mean of 112+39.8mmol/L at 6 years after conversion. The systolic and diastolic blood pressure also remained significantly reduced (p < 0.01), while the moan number of antihypertensive drugs decreased. In 9 (15%)and 3 (6.7%) patients an acute rejection (within 3 months after conversion) and late rejection ( >3 months after conversion) developed, respectively. patient /graft survival were 95% /81. 7% ,86. 7% /78. 3% at 1 and 5 years after conversion, respectively. Conclusions Our results shew that conversion from CsA to AZA at 1 years aiter renal thansplantation is a safe immunosuppressive strategy with excellent graft survival in the longterm更多还原