环孢素与他克莫司免疫抑制方案治疗肾移植术后患者的疗效比较  

Comparison of curative effect of immunosuppression scheme with cyclosporine and tacrolimus in the treatment of patients after renal transplantation

作　　者：张春铜 刘杰[1] 杨柳 吕红光[1] 马冲 董悦 ZHANG Chuntong;LIU Jie;YANG Liu;LYU Hongguang;MA Chong;DONG Yue(Department of Pharmacy,Huainan Chaoyang Hospital,Anhui Province,Huainan 232007,China)

机构地区：[1]淮南朝阳医院药剂科,安徽省淮南市232007

出　　处：《临床合理用药杂志》2024年第33期28-31,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：淮南市科技计划项目(2020131)。

摘　　要：目的比较环孢素与他克莫司免疫抑制方案对肾移植术后患者的治疗效果。方法回顾性选取2021年1月—2022年12月淮南朝阳医院收治的肾移植术后患者51例,根据患者治疗方案不同分为他克莫司组(TAC组)30例和环孢素组(CSA组)21例。TAC组患者采用他克莫司、吗替麦考酚酯联合泼尼松治疗,CSA组患者采用环孢素、吗替麦考酚酯联合泼尼松治疗,2组患者治疗时间需根据具体病情而定。比较2组治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总蛋白(TP)、白蛋白(Alb)和总胆红素(TBil)]、肾功能指标[肌酐(Cr)、血尿素氮(BUN)和尿酸(UA)]、葡萄糖(GLU)、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血常规[白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)和血小板计数(PLT)]。结果治疗结束后,2组ALT、TP、Alb、TBil、UA、GLU、血脂指标、WBC、PLT比较,差异无统计学意义(P>0.05);TAC组HDL-C水平低于治疗前,且TAC组血清AST、Cr、BUN水平低于CSA组,RBC及Hb水平高于CSA组(P<0.05或P<0.01)。结论环孢素与他克莫司免疫抑制方案对肾移植术后患者的肝功能和糖脂代谢均无较大影响,但与他克莫司相比,环孢素较易引起肾损伤和贫血。Objective To compare the curative effect of immunosuppression scheme with cyclosporine and tacrolimus in the treatment of patients after renal transplantation.Methods A total of 51 cases of patients after renal transplantation admitted to Huainan Chaoyang Hospital from January 2021 to December 2022 were retrospectively enrolled,the patients were divided into TAC group(30 cases)and CSA group(21 cases)according to different treatment scheme.Patients in the TAC group were treated with tacrolimus,mycophenolate mofetil combined with prednisone,and patients in the CSA group were treated with cyclosporine,mycophenolate mofetil combined with prednisone,the treatment time of two groups of patients depended on the specific condition.Liver function indexes(ALT,AST,TP,Alb,TBil),kidney function indexes(Cr,BUN,UA),GLU,lipid metabolism indexes(TC,TG,LDL-C,HDL-C)and blood routine(WBC,RBC,Hb,PLT)before and after treatment in the two groups were compared.Results At the end of treatment,there was no significant difference in ALT,TP,Alb,TBil,UA,GLU,lipid metabolism indexes,WBC or PLT between the two groups(P>0.05);HDL-C level of TAC group was lower than that before treatment,and serum levels of AST,Cr,BUN in the TAC group were lower than those of the CSA group,RBC and Hb level were higher than those of the CSA group(P<0.05 or P<0.01).Conclusion The immunosuppressive regimen of cyclosporine and tacrolimus has no significant effect on liver function,glucose and lipid metabolism of patients after renal transplantation,but compared with tacrolimus,cyclosporine is more likely to cause renal injury and anemia.

关 键 词：肾移植术后 环孢素 他克莫司 免疫抑制剂 肾功能 血红蛋白 

分 类 号：R699.2[医药卫生—泌尿科学]