应用他克莫司治疗早期慢性移植肾功能不全的临床研究  

Tacrolimus in the treatment on early stage of chronic renal allograft dysfunction

作　　者：李晓北[1] 尹航[1] 胡小朋[1] 王玮[1] 张勇[1] 马麟麟[1] 王勇[1] 张小东[1] 

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科

出　　处：《中国现代医药杂志》2007年第9期9-11,共3页Modern Medicine Journal of China

摘　　要：目的分析他克莫司(FK506)替代环孢素(CsA)治疗早期慢性移植肾功能不全的临床效果。方法对28例肾移植术后服用CsA保持肾功能正常6个月以上的患者出现慢性移植肾功能不全(血肌酐SCr>190μmol/L)后应用FK506,严格监测血药浓度使之维持在4～6μg/L。结果18例治疗前血肌酐低于300μmol/L的患者经FK506治疗后血肌酐水平较治疗前下降明显,其中5例患者(27.8%)血肌酐降至正常,其余患者血肌酐下降幅度均超过50μmol/L,高血压、高血脂及转氨酶异常等状况亦有所改善,随访4个月以上,病情稳定;但10例治疗前血肌酐超过300μmol/L的患者,其中7例肾功能变化不明显,SCr变化幅度在±50μmol/L之间,另有3例在转换治疗后肌酐升高,且幅度超过50μmol/L。结论对于早期慢性移植肾功能不全,用FK506替代CsA治疗可作为一项有效的临床选择方案。Objective To evaluate the efficacy of tacrolimus substituting for Cyclosporine （CsA） in the treatment on early stage of chronic renal allografi dysfunction （CRAD）. Methods 28 patients with chronic renal function dysfunction （SCr〉 190μmol/L）received the treatment of Tacrolimus substituting for CsA. All the patients had taken CsA post-transplant and kept normal kidney function for at least 6 months prior to the development of CRAD. The whole blood trough concentration of Tacrolimus was adjusted to maintain 4-6μg/L by cautious monitoring. Results In 18 patients whose SCr were less than 300μmol/L before the treatment of Tacrolimus, the SCr had decreased markedly. Several symptoms such as hypertension, hyperlipidemia, aminotransferase abnormality were improved to some extent. Among them, 5 patients （27.8%） resumed normal kidney function eventually and the value of SCr in the rest 13 patients decreased more than 50μmol/L. All 18 patients kept renat allograft function steadily during more than 4 months follow-up. No significant changes of the SCr happened in 7 patients whose SCr were more than 300μmol/L before the treatment, while the SCr level was more than 50μmol/L higher than before in other 3 patients who had the same situations. Conclusion The regimen of Tacrolimus substituting for CsA is probably a good choice for the patients who suffered early stage of chronic renal allograft dysfunction.

关 键 词：移植肾功能不全 他克莫司 环孢素 

分 类 号：R699.2[医药卫生—泌尿科学]