五酯软胶囊在肾移植术后应用的临床研究(附60例报告)  

Application of WuZhi soft capsule for liver injury after renal transplatation:60 cases report

作　　者：陈夏[1] 蔡宪安[1] 

机构地区：[1]郑州市中心医院泌尿外科,450007

出　　处：《器官移植》2011年第5期283-286,共4页Organ Transplantation

摘　　要：目的探讨五酯软胶囊治疗肾移植术后因服用环孢素(CsA)致肝损害患者的效果及对CsA血药谷浓度的影响。方法将60例采用环孢素(CsA)+麦考酚吗乙酯(MMF)+泼尼松三联免疫抑制方案治疗3个月以上出现肝损害的肾移植术受者作为研究对象,加服五酯软胶囊(每粒0.5g含五味子甲素6mg),每次0.5g、每日3次(A剂量),用药15d后,调整五酯软胶囊用量为每次0.5g、每日2次(B剂量),用药15d后再调整五酯软胶囊用量为每次0.5g、每日1次(C剂量),再应用15d,停服五酯软胶囊5d。加服五酯软胶囊前1d,加服A剂量3d、5d、7d、10d、15d,加服B剂量15d,加服C剂量后15d和停服5d分别测定CsA血药谷浓度。同时监测60例肝损害患者的肝功能、肾功能、空腹血糖和24h尿量。结果与加服五酯软胶囊前比较,加服3d、5d、7d、10d、15d后,CsA血药谷浓度均明显升高(均为P<0.01)。减量(加服B剂量与C剂量)及停服5d后,CsA血药谷浓度明显下降(均为P<0.01)。与加服五酯软胶囊前比较,60例肾移植患者在加服五酯软胶囊后肝功能明显改善,而肾功能、空腹血糖无明显变化。结论肾移植术后肝损害患者应用五酯软胶囊治疗,具有良好的护肝效果,且能明显提高CsA血药谷浓度,可相应减少CsA的服用剂量。Objective To explore the efficacy of WuZhi soft capsule application on patients with liver injury causing by ciclosporin （CsA） after renal transplantation and the influence of WuZhi soft capsule on blood trough concentration of CsA. Methods A total of 60 renal tranplantation recipients with liver injury, who received triple therapy regime [ CsA ＋ mycophenolate mofetil （MMF） ＋ prednisone （Pred） ] for more than 3 months, were involved in the study. They were prescribed with WuZhi soft capsule （with deoxyschizandrin 6 mg in each pili of 0. 5 g）. At first, WuZhi soft capsule was prescribed 0. 5 g each time and three times a day （ A dose）. Fifteen days later, WuZhi soft capsule was adjusted to 0. 5 g each time and twice a day （ B dose）. Another 15 days later, WuZhi soft capsule was adjusted to 0. 5 g each time and once a day （C dose）. WuZhi soft capsule was also used for 15 days and then stopped for 5 days. The blood trough concentration of CsA was measured at 1 d before WuZhi soft capsule prescription, 3 d, 5 d, 7 d, 10 d and 15 d after WuZhi soft capsule prescription with A dose, 15 d after WuZhi soft capsule prescription with B dose, 15 d after WuZhi soft capsule prescription with C dose and 5 d after withdrawal. The biochemical examination of liver fuctions, renal func- tions, fasting blood glucose level and urinary volume for 24 h were measured in the 60 patients. Results Compared with CsA blood trough concentration before WuZhi soft capsule prescription, the blood trough concentrations of CsA were significantly increased at 3 d, 5 d, 7 d, 10 d and 15 d after WuZhi soft capsule prescription （ all in P 〈 0. 01 ）. And the blood trough concentrations of CsA were significantly decreased along with Wuzhi Soft capsule reduction （ prescription with B and C dose） and withdrawal （ all in P 〈 0. 01 ）. The liver function recovered to normal after WuZhi soft capsule administration, while the renal function and fasting blood glucose level showed no significant change. Conclusion

关 键 词：五酯软胶囊 环孢素 肾移植 肝功能 肝损害 

分 类 号：R699.2[医药卫生—泌尿科学]