肾移植术后应用咪唑立宾抗排斥治疗的临床观察  

Mizoribine: An effective and low-toxic immunosuppressant for renal transplantation patients

作　　者：陈劲松[1] 季曙明[1] 沙国柱[1] 程震[1] 孙启全[1] 文吉秋[1] 程东瑞[1] 刘志红[1] 黎磊石[1] 

机构地区：[1]南京军区南京总医院解放军肾脏病研究所,江苏南京210002

出　　处：《医学研究生学报》2009年第1期54-56,60,共4页Journal of Medical Postgraduates

摘　　要：目的:探讨咪唑立宾(MZR)在肾移植术后抗排斥治疗临床的效果及安全性。方法:38例首次接受肾移植的患者采用环孢素(CsA)或他克莫司(FK506)+MZR+泼尼松(Pred)治疗,与同期31例采用CsA或FK506+霉酚酸酯(MMF)+Pred治疗的患者进行比较。观察2组患者在肾移植术后12月内的人、肾存活率及肾功能变化情况,比较2组间急性排斥反应、药物不良反应(外周血白细胞下降、肝功能异常、血尿酸升高及胃肠道症状)以及肺部感染的发生率。结果:随访12个月,MMF组患者人、肾存活率均为100%,MZR组人、肾存活率分别为100%、97.4%。肾移植术后MMF组和MZR组急性排斥反应的发生率相似,2组在肾移植术后1、2、3月的血肌酐差异无统计学意义,在6月和12月MZR组血肌酐较MMF组明显增高(P<0.05);与MMF组相比,MZR组患者的胃肠道症状、肺部感染发生率明显下降(P<0.05),而外周血白细胞下降、高尿酸血症以及肝功能异常等方面的发生率差异无统计学意义。结论:在肾移植中应用MZR安全、不良反应小,可以作为肾移植患者术后常规的免疫抑制剂。Objective： To investigate the effect and safety of Mizoribine （MZR） in allograft kidney transplantation, Methods： Thirty-eight recipients of first allograft kidney transplantation received Pred ＋ CsA or FK506 ＋ MZR while the other 31 Pred ＋ CsA or FK506 ＋ MMF. Comparisons were made between the two groups in the patient/kidney survival rate, SCr, ineidenee of acute rejection, drug toxicity/side effeets （leucopenia, GPT above normal, hyperuricemia and gastrointestinal symptom） and pulmonary infeetion. Results： No significant differenees were observed in the patient/kidney survival rate, acute rejection incidenee and SCr between the two groups 1, 2 and 3 months after the transplantation. Compared with the MMF group, SCr was significantly increased at 6 and 12 months （P 〈 0.05 ）, while the incidenees of gastrointestinal symptoms and pulmonary infeetion markedly decreased in the MZR group （P 〈 0.05 ）. No statistic differences were shown in the incidences of leucopenia, GPT above normal and hyperurieemia between the two groups. Conclusion： MZR, with its high safety and low toxicity/side effects, can be used as a maintenance immunosuppressant after allograft kidney transplantation.

关 键 词：肾移植 免疫抑制剂 咪唑立宾 

分 类 号：R979.5[医药卫生—药品]