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目的:调查肾移植术后患者应用免疫抑制药吗替麦考酚酯(MMF)致白细胞计数降低的关系。方法:回顾性查阅2005～2007年北京友谊医院肾移植术后发生WBC降低的病例23份(除去死亡,移植失败以及数据不全者),对术后WBC白细胞计数降低的患者进行统计,并对比总蛋白降低的患者情况进行分析。结果:23例肾移植患者中,平均年龄(48.30±12.19)岁,WBC减少发生率为6.94%(23/331),6例停用,11例减量。且有1例患者白细胞下降至0.11×10~9·L~(-1)。WBC计数平均3.03×10~9·L~(-1),其中危重度患者2例,重度患者2例。结论:肾移植后应用MMF所致WBC减少并不少见,其发生可能与体内血中游离的霉酚酸浓度较高有关,大多数可逆。肾功能不全者应适当减少MMF的用量。
OBJECTIVE: To investigate the relationship between immunosuppressive agents and leukocyte counts in patients receiving mycophenolate mofetil (MMF) after renal transplantation. Methods: A retrospective review of 23 cases of WBC reduction after renal transplantation (except death, transplantation failure and incomplete data) in Beijing Friendship Hospital from 2005 to 2007 was performed. The patients with postoperative WBC leukopenia were statistically analyzed and compared Patients with reduced protein were analyzed. Results: Among 23 renal transplant recipients, the mean age (48.30 ± 12.19) years old, the incidence of WBC reduction was 6.94% (23/331), 6 were discontinued and 11 were reduced. One patient had leukopenia 0.11 × 10 ~ 9 · L ~ (-1). WBC count averaged 3.03 × 10 ~ 9 · L ~ (-1), including 2 critically ill patients and 2 severe patients. CONCLUSION: It is not uncommon for WBC reduction induced by MMF after renal transplantation to occur, which may be related to the higher concentration of free mycophenolic acid in the blood and most of them are reversible. Renal dysfunction should be appropriate to reduce the amount of MMF.