肾移植术后三种免疫抑制方案不良反应的对比研究  

Comparative Study on the Side Effects of Three Immunosuppressant Regimens in Recipient Renal Allograft

作　　者：王福利[1] 秦卫军[1] 刘贺亮[1] 张更[1] 杨晓剑[1] 秦荣良[1] 王禾[1] 袁建林[1] 

机构地区：[1]第四军医大学西京医院泌尿外科,西安710032

出　　处：《临床泌尿外科杂志》2010年第7期507-509,513,共4页Journal of Clinical Urology

摘　　要：目的:评价不同免疫抑制方案在肾移植中应用的安全性。方法:采用前瞻性、随机、对照研究。根据肾移植术后所用免疫抑制方案将180例肾移植患者随机分为3组,A组:环孢霉素A(CsA)+霉酚酸酯(MMF)+泼尼松(Pred);B组:普乐可复(FK506)+MMF+Pred;C组:CsA+硫唑嘌呤(Aza)+Pred。术后随访18～62个月,观察3组用药后的药物不良反应。结果:在不良反应总发生率方面,A、B、C组的差异有统计学意义(x^2=20.05,P<0.05)。在胃肠道反应、肾移植术后糖尿病、感染发生率方面,A、B、C组的差异无统计学意义(x^2=5.07,P>0.05);而在肾毒性、高血压发生率方面,A、B、C组的差异有统计学意义(P<0.05),C组明显高于A、B组;在多毛、牙龈增生、骨髓抑制、高血脂、肝毒性的发生率方面,A、B、C组的差异有统计学意义(P<0.05),A、C组明显高于B组。结论:在药物不良反应方面,以FK506、MMF、Pred组成的免疫抑制方案较CsA、MMF、Pred方案和CsA、Aza、Pred方案相对安全。Objective：To evaluate the safety of different immunosuppressant regimens in renal allograft recipients. Methods： According to different immunosuppressant regimens, 180 renal allograft recipients were randomly divided into three groups： group A receiving cyclosporin A （CsA）, mycophenolate mofeltil （MMF） and Prednisone （Pred） ;group B receiving taerolimus （FK506）, MMF and Pred; group C receiving CsA, azathioprine （Aza） and Pred. The incidences of drug side effects were observed in each group 18 to 62 months after operation. Results： There was obvious significant difference in general incidence rate in the three groups（x^2 = 20.05, P〈0.01）. There was no significant difference in gastrointestinal tract reaction , posttransplant diabetes mellitus and infection rate in the three groups（x^2= 5.07, P〉0.05）. The incidence of renal toxicity and hypertension in group C was obviously higher than in groups A and B （P〈0.05）. The incidence of hairiness,gingival hyperplasia,arrest of bone marrow, hyperlipidemia and liver toxicity in groups A and C was obviously higher than in groups B （P〈0.05）. Conclusions： At the aspect of drug side effects,the immunosuppressant regimen of FK506, MMF and Pred was relatively safer than the immunosuppressant regimens of CsA, MMF, Pred And CsA, Aza, Pred.

关 键 词：肾移植 免疫抑制方案 不良反应 

分 类 号：R699.2[医药卫生—泌尿科学]