摘要
背景:近年来,多项研究表明环孢素A转换成他克莫司的免疫抑制方案对慢性移植肾肾病有一定疗效。目的:探讨他克莫司替换环孢素A联合雷公藤多甙片治疗慢性移植肾肾病的疗效及安全性。方法:回顾性分析经临床及病理证实为慢性移植肾肾病的患者57例,诊断前均采用环孢素A+吗替麦考酚酯+泼尼松免疫抑制治疗,然后根据不同的治疗方案分成两组:环孢素A组(n=27),继续采用原方案治疗;他克莫司+雷公藤多甙片组(n=30),环孢素A切换成他克莫司的同时再联用雷公藤多甙片治疗。结果与结论:转换后3,6个月两组间血肌酐、24h尿蛋白水平比较差异均有显著性意义(P<0.05),各组3个月与6个月的血肌酐、24h尿蛋白水平比较差异均无显著性意义(P>0.05),血总胆固醇、三酰甘油、丙氨酸氨基转换酶、天冬酸氨基转换酶等指标两组间差异无显著性意义(P>0.05)。他克莫司+雷公藤多甙片组震颤发生率较环孢素A组高(P<0.05),但高血压、多毛症、血糖升高、牙龈增生的发生率显著低于环孢素A组(P<0.05)。结果表明他克莫司替换环孢素A联合雷公藤多甙片的治疗方案对慢性移植肾肾病有显著的疗效,且安全性能好,有助于移植肾的长期存活。
BACKGROUND：In recent years,several studies have shown that immunosuppressive regimen of tacrolimus conversed from cyclosporine A（CsA） has a certain effect on chronic allograft nephropathy.OBJECTIVE：To investigate the clinical efficacy and safety of conversion from CsA to tacrolimus combined with Tripterygium wilfordii Hook.f.（TII） on CAN.METHODS：Retrospectively analysis of 57 patients with chronic allograft nephropathy diagnosed by clinical and pathological identification.The patients were treated with CsA＋mycophenolate mofetil＋prednisone immunosuppressive therapy before diagnosis,and then the patients were divided into two groups according to different treatment options：CsA group（n=27） which was continued to use the initial therapy,CsA＋TII group（n=30） was treated by tacrolimus instead of CsA combined with TII.RESULTS AND CONCLUSION：There was significant difference on the level of serum creatinine and quantity of 24-hour urine protein excretion in two groups at 3 and 6 months after conversion（P 0.05）,but there were no statistical difference of those in each group at 3 and 6 months（P 0.05）.And there were no significant differences on the level of total cholesterol,triacylglycerol,alanine aminotransferase and aspartic acid aminotransferase between two groups（P 0.05）.The tremor incidence in CsA＋TII group was obviously higher than that in the CsA group（P 0.05）,but the incidence of hypertension,hypertrichosis,hyperglycemia and gingival overgrowth in CsA＋TII group was significantly lower than that in the CsA group（P 0.05）.Conversion from CsA to tacrolimus combined with TII has a good efficacy for the treatment of chronic allograft nephropathy in kidney transplant recipients with fewer adverse effects,which benefits for the long-term survival of allograft.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
2012年第5期801-804,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
