肝移植受者单用霉酚酸类药物远期疗效评价  

Long-term efficacy of mycophenolic acid monotherapy in liver transplantation recipients

作　　者：李莉 史斌 金海龙 牛鑫鑫 李威[2] 潘宜鹏 Li Li;Shi Bin;Jin Hailong;Niu Xinxin;Li Wei;Pan Yipeng(Department of Transplantation,the Third medical center of PLA general hospital,Beijing 100039,China;Department of Transplantation,the Second Affiliated Hospital of Hainan Medical University,Haikou 570100,Hainan,China)

机构地区：[1]中国人民解放军总医院第三医学中心器官移植科,北京100039 [2]海南医学院第二附属医院肝脏移植科,海南海口570100

出　　处：《实用器官移植电子杂志》2023年第5期447-450,共4页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的探讨肝移植受者术后单用霉酚酸(mycophenolic acid,MPA)类药物的远期疗效。方法回顾性分析2002年9月至2021年8月期间解放军总医院第三医学中心30例肝移植受者临床资料,上述病例从钙调磷酸酶抑制剂(calcineurin inhibitor,CNI)方案因肾毒性转换为单药霉酚酸类药物免CNI类方案,并对转换前后肝功能、肾功能以及其不良反应进行对比分析,随访周期为2年。结果转换后1年与转换后2年的肌酐(creatinine,Cr)水平分别为(83.5±24.3)μmol/L(、74.2±15.9)μmol/L。估算的肾小球滤过率(estimated glomerular filtration rate,e GFR)分别为(77.7±9.1)ml/min、(86.1±6.5)ml/min。与转换前比较,Cr水平明显降低(P<0.05),e GFR水平得到明显提高(P<0.05)。丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBil)水平前后无明显变化(均P>0.05)。结论肝移植远期的受者霉酚酸类药物单药维持,其安全性值得肯定,无明显不良反应,且其肾功能水平可从免CNI抗排斥方案中获益。Objective To investigate the long-term efficacy of mycophenolic acid monotherapy in liver transplantation recipients.Methods The clinical data of 30 liver transplantation recipients in the Third Medical Center of PLA General Hospital from September 2002 to August 2020 were retrospectively analyzed.These patients were converted from CNI regimen to MPA(CNI free)regimen due to toxicity,and their liver and kidney functions and adverse effectwere compared before and after the conversion.The follow-up period was 2 years.Results The creatinine(Cr)levels at 1 and 2 years after conversion were(83.5±24.3)μmol/L and(74.2±15.9)μmol/L,respectively.The Cr level was significantly lower than that before conversion(P<0.05).The estimated glomerular filtration rate(eGFR)was(77.7±9.1)ml/min and(86.1±6.5)ml/min,respectively.The eGFR level was significantly increased(P<0.05).The alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)levels had no significant changes before and after conversion(ALL P>0.05).Conclusion The efficacy of mycophenolic acid monotherapy in long-term recipients of liver transplantation is worth affirming.

关 键 词：肝移植 霉酚酸 远期疗效 钙调磷酸酶抑制剂毒性 

分 类 号：R657.3[医药卫生—外科学]