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目的:评价肾移植术后应用雷帕霉素(sirolimus,SRL)的疗效和药物的不良反应。方法:实验组:20例同种异体尸体供肾移植患者,免疫抑制方案为环孢素A(CsA)+SRL+强的松(Pred);对照组:15例同种异体尸体供肾移植患者,免疫抑制方案为CsA+霉酚酸酯(MMF)+Pred。对比二组在术后6个月内的疗效和药物的不良反应。结果:两组患者肾脏6个月内均带功能存活。实验室检查无统计学差异,但急性排斥发生率、并发症及药物的副作用明显不同。实验组(n=20):急性排斥1例(5%),移植肾功能延迟1例(5%),肺部感染3例(15%),血脂异常11例(55.0%,胆固醇升高3例,三酰甘油升高4例,二者皆升高4例),肝功能异常3例(15%);对照组(n=15):急性排斥2例(13.3%),肺部感染2例(13.3%),血脂异常5例(33.3%,胆固醇升高1例,三酰甘油升高2例,二者皆升高2例);腹泻6例(40%),白细胞减少1例。结论:肾移植术后应用CsA+SRL+Pred三联免疫抑制治疗方案,其急性排斥发生率低于CsA+MMF+Pred的方案,但血脂异常发生率较高。
Objective: To evaluate the efficacy and adverse drug reactions of sirolimus (SRL) after renal transplantation. Methods: The experimental group: 20 patients with allograft donor kidney transplantation, the immunosuppressive regimen was CsA + SRL + prednisone; Control group: 15 patients with allograft donor kidney transplantation, The immunosuppressive regimen was CsA + mycophenolate mofetil (MMF) + Pred. The two groups were compared within 6 months after the efficacy and adverse drug reactions. Results: The kidneys of both groups survived within 6 months. Laboratory tests showed no significant difference, but the incidence of acute rejection, complications and drug side effects were significantly different. In the experimental group (n = 20), acute rejection (1%), delayed graft function in 1 case (5%), pulmonary infection in 3 cases (15%), dyslipidemia in 11 cases (55.0% In the control group (n = 15), 2 cases (13.3%) of acute rejection, 2 cases of pulmonary infection Cases (13.3%), dyslipidemia in 5 cases (33.3%, cholesterol increased in 1 case, triglyceride increased in 2 cases, both increased 2 cases); diarrhea in 6 cases (40%), leukopenia in 1 case. Conclusion: CsA + SRL + Pred triple immunosuppressive regimen after renal transplantation has a lower incidence of acute rejection than CsA + MMF + Pred, but the incidence of dyslipidemia is higher.