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目的探讨免疫抑制剂他克莫司和雷帕霉素对肝癌肝移植术后受者治疗预后的比较。方法将22例肝癌肝移植术后患者随机分为两组:FK506组11例:术后采用FK506+MMF+Pred方案;Rapa组11例:术后4周内采用FK506+MMF+Pred方案,4周后改用Rapa+MMF+Pred方案。比较两组患者术后的肿瘤复发情况、死亡(因肿瘤因素)、排斥反应、感染发生率及肝、肾功能等情况。结果 FK506组患者与Rapa组患者在术后急性排斥反应、感染发生率、同时期的谷丙转氨酶(ALT)浓度方面差异无统计学意义(P>0.05);两组患者在术后肿瘤复发率、死亡率、血肌酐(CREA)浓度方面差异有统计学意义(P<0.05),Rapa组患者比FK506组患者术后疗效更好。结论雷帕霉素能明显改善肝癌肝移植术后患者的预后,并无肾功能损害,且不增加排斥反应的发生率,为肝癌肝移植术后的治疗提供了一种新的选择。
Objective To investigate the prognosis of recipients of liver cancer after liver transplantation with immunosuppressive agents such as tacrolimus and rapamycin. Methods Twenty-two patients with hepatocellular carcinoma after liver transplantation were randomly divided into two groups: FK506 group (n = 11), FK506 + MMF + Pred regimen postoperatively, Rapa group (n = 11) Switch to Rapa + MMF + Pred program after week. Tumor recurrence, death (due to tumor factors), rejection, incidence of infection and liver and kidney function were compared between the two groups. Results There was no significant difference in postoperative acute rejection, incidence of infection and ALT concentration between the FK506 group and the Rapa group (P> 0.05). The postoperative recurrence rate , Mortality and serum creatinine (CREA) levels were significantly different (P <0.05), Rapa group than FK506 group patients with better outcome. Conclusion Rapamycin can significantly improve the prognosis of patients with liver cancer after liver transplantation, without renal impairment, and does not increase the incidence of rejection, providing a new choice for the treatment of liver cancer after liver transplantation.