西罗莫司转换治疗对肾移植受者血脂的影响及辛伐他汀的降脂效果  

Effects of sirolimus on blood lipids of renal transplant recipients and therapeutic effects of simvastatin

作　　者：丰贵文[1] 王志刚[1] 李金锋[1] 庞新路[1] 崔芝利 刘磊[1] 谢洪昌[1] 丰永花[1] 郭战[3] 尚文俊[1] 

机构地区：[1]郑州大学第一附属医院肾移植科,郑州450052 [2]郑州大学第三附属医院儿科,郑州450052 [3]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《郑州大学学报（医学版）》2014年第1期69-72,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金资助项目U1204820;郑州大学第一附属医院青年基金资助项目2011-QN010

摘　　要：目的:探讨西罗莫司转换治疗对肾移植受者血脂的影响以及辛伐他汀的降脂效果。方法:对106例使用西罗莫司替代钙调磷酸酶抑制剂转换治疗的肾移植受者随访1 a,观察高脂血症发生率。符合转换后高脂血症治疗标准的患者48例,给予辛伐他汀10 mg/d,晚间顿服;监测辛伐他汀治疗4周、8周后各项血脂指标、肝肾功能和不良反应发生情况。结果:106例中2例因出现大量蛋白尿而提前退组。1 a内高脂血症的发生率为46.2%(48/104)。与治疗前相比,辛伐他汀治疗4周、8周TC、TG、LDL-C下降,HDL-C升高(P<0.05);辛伐他汀治疗8周降脂效果优于4周(P<0.05),未见严重不良反应。结论:西罗莫司可致肾移植受者高脂血症;合用辛伐他汀降脂治疗安全性好,疗效确切、显著。Aim：To investigate the effects of sirolimus substitution of calcineurin inhibitors on blood lipids of renal transplant recipients and clinical efficacy and safety of simvastatin .Methods： A total of 106 renal transplant recipients were given sirolimus and followed up for 1 year.The patients developed hyperlipidemia were recorded and treated with sim-vastatin at 10 mg/d.The lipids, liver and kidney function , and adverse reactions at 4 weeks and 8 weeks after the treat-ment were observed .Results：Two cases retired the study due to massive proteinuria .The incidence of hyperlipidemia was 46.2%（48/104）.Compared with before, the serum TC,TG,and LDL-C decreased while serum HDL-C increased after 4 weeks and 8 weeks treatment of simvastatin without serious adverse events （ P＆lt;0.05 ）; the lipid-lowering efficacy of 8 weeks treatment was better than that of 4 weeks.Conclusion：Sirolimus leads to hyperlipidemia in renal transplant recipi-ents;simvastatin combination could down-regulate serum lipids efficiently and safely .

关 键 词：西罗莫司 肾移植 高脂血症 辛伐他汀 

分 类 号：R699.2[医药卫生—泌尿科学]