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对27例术后6个月~8年7个月发生慢性排斥的肾移植患者进行治疗,21例经治疗后血清肌酐明显下降,并稳定,6例病情有反复。比较不同时期的免疫抑制剂用量,发现稳定组在慢性排斥发生后1、3、6个月时环孢素A、强的松、硫唑嘌呤的用量均明显高于治疗前,而不稳定组在上述时期的免疫抑制剂用量不高于或低于治疗前。认为长期应用较大剂量的免疫抑制剂(尤其是环孢素A)是维持慢性排斥治疗效果的关键,并应充分重视硫唑嘌呤的作用,而某些辅助用药可有效防治大剂量免疫抑制剂所带来的不良后果。
Twenty-seven patients with chronic allograft rejection were treated 6 months to 8 years and 7 months after operation. Serum creatinine was significantly decreased in 21 patients and stabilized after treatment. The disease was repeated in 6 patients. Compared with the dosage of immunosuppressive agents in different periods, we found that the dosage of cyclosporin A, prednisone and azathioprine in the stable group were significantly higher than those before treatment at 1, 3 and 6 months after chronic rejection The amount of immunosuppressive agent during the above period was not higher or lower than before treatment. The long-term use of larger doses of immunosuppressive agents (especially cyclosporin A) is the key to maintain the therapeutic effect of chronic rejection, and should give full consideration to the role of azathioprine, and some adjuvant drugs can effectively prevent and treat large doses of immunosuppressive agents The resulting adverse consequences.