“新三联”疗法预防肾移植术后的急性排斥反应  

The Effect of "New Triple Immunosuppressant Regimen" on Prevention of Acute Rejection of Renal Transplant Recipient

作　　者：王甫剑[1] 吴天麟[1] 朱同玉[2] 

机构地区：[1]东南大学医学院附属徐州医院泌尿外科,徐州221009 [2]复旦大学附属中山医院泌尿外科,上海200032

出　　处：《中国临床医学》2004年第2期207-208,237,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨新三联疗法在预防肾移植术后急性排斥反应的效果。方法:1996年10月-2000年10月间肾移植患者119例,分为2组,其中新三联组(霉酚酸脂+环孢霉素A+强的松)59例,传统组(硫唑嘌呤+环孢素A+强的松)60例。结果:随访6-20个月,新三联组急性排斥反应发生率为10.17%(6/59)(P<0.01)环孢素A的剂量为(3.46±0.29)mg·kg-1·d-1,血CsA谷浓度(107±10.14)μg/L;传统组急性排斥反应发生率为31.67%(19/60),环孢素A剂量(6.56±0.67)mg·kg-1·d-1,血CsA谷浓度187.6±7.8μg/L,且新三联组未见有肝肾毒性等并发症,仅表现有腹泻等胃肠道并发症。结论:新三联疗法有减少和预防肾移植术后急性排斥反应的效果,且可减少环孢素A的用量,减少肾移植患者的肝肾毒性作用。Objective: To investigate the effect of new tripe immunosuppressant regimen on prevention of early acute rejection after renal transplantation. Methods: 119 cadaveric renal transplantation recipient were analyzed retrospectively from October 1996 to October 2000, they were divided into two groups :New tripe regimen group: ( MMF+CsA+Pred) (n=59 ) and traditional triple group (CsA+Aza+Pred) (n=60). Results: The incidence of acute rejection were 10.2% (6/59) (p<0.01) in group new triple regimen and 31.7% (19/60) in traditional group respectively within 6-20 month after renal transplantation. The dosage of CsA and blood concentration of CsA were significantly lower in new tripe regimen group than those in traditional group (3.46±0.29 vs 6.56±0.67 mg. kg-1·d-1and 107±10.14 vs 187.6±7.8μg/l). New triple therapy did not have nephrotoxicity and liver toxicity. Conclusion:New triple immunosuppressant therapy may decrease and prevent acute rejection, and decrease the dosage of CSA and toxicity of liver and kidney.

关 键 词：新三联疗法 预防 肾移植 术后并发症 急性排斥反应 霉酚酸脂 环孢霉素A 强的松 

分 类 号：R699.2[医药卫生—泌尿科学]