肾移植术后“爬行肌酐”患者使用他克莫司替换环孢素A疗效观察  

Conversion from cyclosporine to tacrolimus in kidney transplant recipients with creeping creatinine

作　　者：倪晓洁[1] 蔡勇[1] 杨亦荣[1] 郑少玲[1] 夏鹏[1] 陈必成[1] 吴存造[1] 孙贤斌[1] 

机构地区：[1]温州医学院附属第一医院,浙江温州325000

出　　处：《山东医药》2008年第9期25-27,共3页Shandong Medical Journal

摘　　要：目的观察他克莫司(FK506)替换环孢素A(CsA)逆转肾移植术后"爬行肌酐"的可行性。方法24例肾移植患者术后均采用以CsA为主的三联免疫抑制方案,出现"爬行肌酐"后用FK506替换CsA。观察替换前后的移植肾功能变化,同时监测血压、抗高血压药物分值(AHS值)、血糖和血脂的变化,随访12个月。结果"爬行肌酐"患者采用FK506替换CsA后,移植肾功能较替换前明显好转,血肌酐下降明显(P<0.05);同时降低了血脂水平,并减少降脂药物及抗高血压药物的使用。结论肾移植术后"爬行肌酐"患者采用FK506替换CsA的治疗方案可以有效地改善或者稳定移植肾的功能。Objective To investigate the therapeutic effect of substituting tacrolimus （FK506） for cyclosporine （CsA） on reversing creeping creatinine in kidney transplant recipients. Methods 24 kidney recipients took the triple immunosuppressive regimen including cyclosporine, MMF and steroid after transplantation. CsA was replaced by FK506 after creeping creatinine appeared. Serum creatinine were monitored 12 months after conversion. Blood pressure, antihypertensive score （ AHS）, blood glucose and lipid profiles were also observed. Results After conversion from CsA to FK506 in patients with creeping creatinine for 12 months, there was a significant improvement in kidney function and serum creatinine was declined significantly. Lipid profiles, especially triglyceride, decreased significantly （ P 〈 0.05 ）, and the dose of lipidlowering drugs and antihypertensive therapy were also reduced. Conclusion In kidney recipients with creeping creatinine, the conversion therapy from cyclosporine to tacrolimus can improve or stabilize the function of kidney allograft effectively.

关 键 词：肾移植 爬行肌酐 他克莫司 环孢菌素 

分 类 号：R617[医药卫生—外科学]