不同免疫抑制方案对高龄肾移植受者长期存活的临床研究  

Clinical Study of Different Immunosuppressive Regiments on Elder Patients with Kidney Transplantation

作　　者：丰贵文[1] 赵显国[1] 王跃[1] 魏金星[1] 高建光[1] 

机构地区：[1]郑州大学第一附属医院器官移植中心,郑州450052

出　　处：《中国临床医学》2004年第4期601-603,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :回顾分析不同免疫抑制方案对高龄肾移植受者长期人 /肾存活的影响。方法 :5 4例高龄肾移植患者分为两组 :组1术后用药方案为环孢素A(CsA) +硫唑嘌呤 (Aza) +泼尼松 (Pred) 30例 ;组 2术后用药方案为抗淋巴细胞球蛋白 (ALG) +CsA+霉酚酸酯 (MMF) +Pred 2 4例。观察患者 1、3、5年的人 /肾存活率 ,急性排斥发生率 ,移植肾功能 ,病毒感染发生率以及血脂情况。结果 :组 1与组 2相比 ,1、3、5年的人 /肾存活率分别为 86 .7% / 80 %、76 .7% / 6 0 %、6 0 % / 4 3.3%vs 95 .8% / 95 .8%、91.7% / 87.5 %、83.3% / 75 % ,两组病人同一时期人 /肾存活率相比 ,有显著差异 (P <0 .0 5 ) ;急性排斥率分别为 4 0 %vs 2 5 % ,(P <0 .0 5 ) ;1、3、5年时血清肌酐 (SCr)值 92± 15 .3μmmol/L ,118± 2 3.5 μmmol/L ,16 3± 31.9μmmol/Lvs 88±17.4 μmmol/L ,10 2± 2 1.7μmmol/L ,12 4± 2 6 .3μmmol/L ,两组病人分别在第 3、5年时的Cr值有显著差异 (P <0 .0 5 ) ;5年内病毒感染发生率分别为 2 3.3%vs 2 0 .8% ,无显著差异 (P >0 .0 5 ) ;高脂血症发生率 70 %vs 4 5 .8% ,有显著差异 (P <0 .0 5 )。结论 :ALG +CsA +MMF +Pred方案安全、有效 ,优于CsA +AzaObjective: To investigate the effect of the different immunosuppressive regiments on long-term recipient/graft survival of elder patients with kidney transplantation(KT). Methods: 54 elder patients with KT were divided into two groups: Group 1 (30) were given CsA+Aza+Pred after KT; Group 2 (24) were given ALG+CsA+MMF+Pred after KT. Recipient/graft survival rate at 1、3、5 year after KT, acute rejection rate, graft function, virus infection rate and blood lipid profile were observed. Results: The recipient/graft survival rate were 86.7%/80%、76.7%/60%、60%/43.3% vs 95.8%/95.8%、91.7%/87.5%、83.3%/75% at 1、3、5 year after KT(Group 1 vs Group 2, P<0.05, respectively), acute rejection rate were 40% vs 25% (Group 1 vs Group 2, P<0.05), SCr were respectively 92±15.3μmmol/L, 118±23.5μmmol/L, 163±31.9 μmmol/L vs 88±17.4μmmol/L, 102±21.7μmmol/L, 124±26.3μmmol/L at 1、3、5 year after KT(Group 1 vs Group 2), SCr at 3、5 year have significant difference (Group 1 vs Group 2, P<0.05), virus infection rate were 23.3% vs 20.8% (Group 1 vs Group 2, P>0.05) within 5 years after KT, hyperlipidemia rate were 70% vs 45.8% (Group 1 vs Group 2, P<0.05). Conclusion:The strategy of ALG+CsA+MMF+Pred is safe, effective and better than that of CsA+Aza+Pred for the long-term recipient/graft survival of elder patients with KT.

关 键 词：免疫抑制方案 高龄 肾移植 长期存活 抗淋巴细胞球蛋白 硫唑嘌呤 环孢素A 泼尼松 

分 类 号：R699.2[医药卫生—泌尿科学] R979.5[医药卫生—外科学]