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目的观察肾移植后应用雷帕霉素(Rap)进行免疫抑制治疗的有效性和安全性。方法将接受首次尸体肾移植的患者50例随机分为两组,研究组30例,术后采用Rap、环孢素A(CsA)和泼尼松(Pred)预防急性排斥反应;对照组20例,术后采用硫唑嘌呤、CsA及Pred预防急性排斥反应。两个组CsA和Pred的用法和用量相同。密切观察和详细记录手术后发生的不良事件,并定期对实验室各项指标进行分析。结果研究组如期完成观察的例数为26例,对照组为18例。在观察的104周内,两组的人、肾存活率为100%;研究组和对照组急性排斥反应的发生率分别为3.7%(1/27)和25.0%(5/20),经激素冲击治疗后逆转;研究组在维持血CsA浓度与对照组相当的情况下,其CsA的用量低于对照组;研究组血胆固醇总量和甘油三酯的水平明显高于对照组。结论Rap用于预防肾移植后急性排斥反应是安全有效的,其与CsA合用可减少CsA的用量,Rap的副作用主要是导致血脂升高。
Objective To observe the effectiveness and safety of rapamycin (Rap) for immunosuppressive therapy after renal transplantation. Methods Fifty patients undergoing the first cadaveric renal allograft were randomly divided into two groups. The study group consisted of 30 patients. After the operation, Rap, CsA and Pred were used to prevent acute rejection. In the control group, 20 patients Postoperative use of azathioprine, CsA and Pred to prevent acute rejection. The usage and dosage of CsA and Pred in both groups are the same. Close observation and detailed records of adverse events after surgery, and regular laboratory analysis of the indicators. Results The study group completed the scheduled number of cases as scheduled 26 cases, the control group was 18 cases. During the 104 weeks of observation, the survival rate of both groups was 100%. The incidences of acute rejection in study group and control group were 3.7% (1/27) and 25.0% (5/20), respectively. Hormone The impact of treatment after reversal; the study group in the maintenance of blood CsA concentration and the control group, the case of its CsA dosage was lower than the control group; study group total cholesterol levels and triglyceride levels were significantly higher than the control group. Conclusion Rap used to prevent acute rejection after renal transplantation is safe and effective, and its combination with CsA can reduce the amount of CsA, Rap side effects mainly lead to elevated blood lipids.