肺移植术后免疫治疗方案的探讨  

Immunosuppressive therapy after human lung transplantation

作　　者：曹克坚[1] 高成新[1] 秦元[1] 胡定中[1] 施建新[1] 杨骏[1] 

机构地区：[1]上海交通大学附属上海市胸科医院胸外科,200030

出　　处：《中华外科杂志》2007年第12期818-821,共4页Chinese Journal of Surgery

摘　　要：目的总结肺移植术后急性排斥反应的诊断和治疗,探讨优化的免疫抑制方案对提高肺移植术后排斥反应的疗效。方法 2002年11月至2006年6月,行肺移植手术16例,其中单肺移植7例、双肺移植9例,免疫抑制方案采用他克莫司(FK506)、霉酚酸酯(骁悉)和泼尼松为主的新三联和(或)辅以赛尼哌治疗。结果本组中除早期2例双肺移植术中因出现严重的肺水肿和早期移植肺失功能死亡外,其余14例手术成功,术后急性排斥反应发生率为21.4%(3/14)。应用赛尼哌辅助方案的8例患者术后6个月内无移植后急性排斥反应。在三联方案的6例中,术后有3例出现急性排斥反应。结论他克莫司、骁悉和泼尼松为主的新三联和(或)辅以赛尼哌治疗方案,在预防肺移植后患者早期急性排斥反应有较好疗效。Objective To summarize the diagnosis and treatment of acute rejection after lung transplantation and to discuss optimized immunosuppressive therapy. Methods Between November 2002 and June 2006,16 patients underwent operations on lung transplantation, 7 cases on single-lung transplantation and 9 cases on bilateral-lung transplantation. Immunosuppressive therapy was new triple drug maintenance regimen including tacrolimus （ Tac ）, mycophenolate mofetil （ MMF ） and steroids, and （ or ） daclizumab. Results Eight cases in new triple drug maintenance regimen with daclizumab. There is no acute rejection in 6 months. Except 2 of the 8 cases died of early post-lung transplantation sever pulmonary edema and dysfunction, 3 of the rest 6 cases underwent acute rejection incident about 21.4% （3/14）. Conclusion In this group the new triple drug maintenance regimen including tacrolimus （ Tac ）, mycophenolate mofetil （MMF） and steroids, and （or） daclizumab acquired beneficial effect in preventing acute rejection after lung transplantation.

关 键 词：肺 器官移植 急性排斥 免疫抑制 

分 类 号：R655.3[医药卫生—外科学]