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目的 :研究FK5 0 6预防肾移植术后排斥反应的效果和安全性。 方法 :肾移植患者 2 2例 ,其中 1 8例为始用组 ,4例为切换组。FK5 0 6起始用 0 2mg/ (kg·d) ,以后逐步减量 ,3个月后维持血浓度于 3～ 1 2 μg/L水平。切换组于停用CsA 2 4h后应用FK5 0 6 ,剂量和血浓度与始用组相同。同时合并应用MMF 0 5g ,每日 3次口服 ,以及术后前 1 0天大剂量甲基强的松龙静滴 ,第 1 1天改强的松口服并减量 ,6个月后维持强的松 1 5mg/d。所有病例均严密观察并行血尿等生化分析。 结果 :始用组移植肾功能好 ,平均血肌酐水平 1 0 2 μmol/L ,无一例出现排斥反应。切换组中 2例异常的肝功能好转 ;肾功能进行性减退的 2例切换后 ,血肌酐相对稳定。有血糖升高 4例和高血压 5例 ,用药后能控制 ,其他副反应有上呼吸道和下尿路感染、胸痛、恶心、呕吐、腹泻、腹部不适等。 结论 :FK5 0 6是肾移植术后有确切疗效的基础抗排斥药 ,与MMF、皮质醇合用能有效地预防急性排斥的发生 ,并可控制慢性排斥的进展。应用剂量适当 ,无明显的肝、肾毒副作用 ,但有血糖升高及高血压副作用 ,药物可以控制。其它呼吸道、尿路、消化道和神经系统副反应轻 ,不妨碍临床用药
Objective: To study the effect and safety of FK5 0 6 in preventing rejection after renal transplantation. Methods: Twenty-two renal transplant recipients were enrolled. Among them, 18 patients were used initially and 4 patients were switched. FK5 0 6 starting with 0 2mg / (kg · d), and then gradually reduce the blood concentration after 3 months to maintain the level of 3 ~ 12μg / L. The switch group applied FK5 0 after 4 h of CsA deactivation, and the dose and blood concentration were the same as the initial group. At the same time, MMF 0 5g was administered orally 3 times a day orally, and large doses of methylprednisolone intravenously 10 days after the operation were administered. On day 1 1, Of pine 1 5mg / d. All cases were closely observed parallel biochemical analysis of hematuria. Results: The initial transplantation group had good renal function with a mean serum creatinine level of 102 μmol / L, with no rejection. In the switch group, 2 cases of abnormal liver function improved; 2 cases of progressive renal dysfunction after switching, serum creatinine was relatively stable. There are 4 cases of elevated blood sugar and 5 cases of hypertension, can be controlled after treatment, other side effects of upper respiratory and lower urinary tract infections, chest pain, nausea, vomiting, diarrhea, abdominal discomfort. Conclusion: FK5 0 6 is the basic anti-rejection drug with definite curative effect after renal transplantation. Combined with MMF and Cortisol can effectively prevent the occurrence of acute rejection and control the progress of chronic rejection. Appropriate dosage, no obvious side effects of liver and kidney toxicity, but with elevated blood sugar and high blood pressure side effects, drugs can be controlled. Other respiratory, urinary tract, gastrointestinal and nervous system side effects, does not prevent clinical medication