肾移植后的蛋白尿  

Proteinuria after kidney transplantation

作　　者：沈蓓莉 杨磊[1] 胡俊杰[1] 王素静[1] 谢红梅[1] 郭晓芳[1] 

机构地区：[1]郑州人民医院肾器官移植科,河南省郑州市450003

出　　处：《中国组织工程研究与临床康复》2011年第53期9953-9956,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:蛋白尿的发生与移植肾的远期存活直接相关,是影响移植肾远期存活、导致肾移植患者死亡的独立危险因素。目的:观察应用血管紧张素Ⅱ受体阻断剂联合雷公藤多苷治疗肾移植后蛋白尿的效果。方法:选择肾移植后出现蛋白尿患者45例,分为3组,在常规应用免疫抑制剂基础上,治疗组采用2倍剂量血管紧张素Ⅱ受体阻断剂联合雷公藤多苷1mg/(kg·d)、雷公藤多苷组采用雷公藤多苷1mg/(kg·d),对照组仅维持原有免疫抑制方案治疗。结果与结论:治疗后12个月治疗组和雷公藤多苷组24h尿蛋白定量、环孢素A血药浓度、环孢素A用量均显著低于对照组(P<0.05),治疗后治疗组尿素氮、肌酐浓度显著低于其他两组(P<0.05)。提示血管紧张素Ⅱ受体阻断剂联合雷公藤多苷能明显减少肾移植后蛋白尿的出现,且可减少免疫抑制剂的用量,对移植肾起保护作用。BACKGROUND： Proteinuria directly correlates with long-term survival of transplanted kidney and is an independent risk factor influencing long-term survival of transplanted kidney and leading to death of transplant patients. OBJECTIVE： To investigate the effects of angiotensin Ⅱ receptor blocker combined with tripterygium glycosides in treatment of proteinuria after kidney transplantation. METHODS： Forty-five patients presenting with proteinuria after kidney transplantation were divided into three groups： treatment, tripterygium glycosides group and control. In the treatment group, based on conventional application of immunosuppressive agent, 2-fold dose of angiotensin Ⅱ receptor blocker combined with tripterygium glycosides （1 mg/kg per day） were used. In the tripterygium glycosides group, tripterygium glycosides （1 mg/kg per day） was used. In the control group, only immunosuppressive agent was used. RESULTS AND CONCLUSION： At 12 months after treatment, 24-hour urine protein, ciclosporin A concentration, ciclosporin A dosage were significantly lower in the treatment and tripterygium glycosides groups than in the control group （P 〈 0.05）. After treatment, urea nitrogen and creatinine levels in the treatment group were significantly lower than those in the control and tripterygium glycosides groups （P 〈 0.05）. These findings suggest that angiotensin Ⅱ receptor blocker combined with tripterygium glycosides can obviously decrease urine protein level after kidney and reduce immunosuppressive agent application dose, exhibiting a protective effect on transplanted kidney.

关 键 词：肾移植 蛋白尿 血管紧张素Ⅱ受体阻断剂 雷公藤多苷 治疗 

分 类 号：R617[医药卫生—外科学]