慢性移植肾肾病患者使用他克莫司联合麦考酚吗乙酯替代环孢素为基础的免疫抑制剂方案的疗效分析

被引:3
作者
刘永光
郭颖
李留洋
陈桦
胡建敏
范礼佩
岳良升
李民
赵明
机构
[1] 南方医科大学珠江医院器官移植科
基金
广东省自然科学基金;
关键词
肾移植; 慢性移植肾肾病; 慢性排斥反应; 他克莫司; 麦考酚吗乙酯; 环孢素;
D O I
暂无
中图分类号
R692.9 [其他疾病];
学科分类号
100221 [泌尿外科学];
摘要
目的探讨应用以环孢素(cyclosporine,CsA)为基础免疫抑制剂的慢性移植肾肾病(chronic allograft nephropathy,CAN)患者转换为他克莫司(tacrolimus,FK506)联合麦考酚吗乙酯(mycophenolate mofetil,MMF)治疗的疗效及安全性。方法使用CsA为基础免疫抑制方案的CAN患者76例,转换为FK506+MMF,随访6个月,根据移植肾穿刺病理结果将患者分为伴有慢性排斥反应组(CR组,41例)和不伴有慢性排斥反应组(non-CR组,35例)。观察两组的疗效及不良反应。结果 CR组好转27例(66%),稳定9例(22%),无效5例(12%);non-CR组好转11例(31%),稳定15例(43%),无效9例(26%),CR组疗效优于non-CR组(P<0.05)。CR组和non-CR组转换后,24h尿蛋白定量均有所降低,高血压和高脂血症的病例数有所减少,而且未出现继发性高血糖、严重感染等不良反应。结论 CAN患者使用FK506+MMF替代CsA为基础的免疫抑制剂方案是安全有效的。
引用
收藏
页码:342 / 344+380 +380
页数:4
相关论文
共 11 条
[1]
New treatments for acute humoral rejection of kidney allografts [J].
Venetz, Jean-Pierre ;
Pascual, Manuel .
EXPERT OPINION ON INVESTIGATIONAL DRUGS, 2007, 16 (05) :625-633
[2]
The aetiology and pathogenesis of chronic allograft nephropathy.[J].P.J. Yates;M.L. Nicholson.Transplant Immunology.2006, 3
[3]
Humoral theory of transplantation: Mechanism, prevention, and treatment [J].
Cai, J ;
Terasaki, PI .
HUMAN IMMUNOLOGY, 2005, 66 (04) :334-342
[4]
Immunosuppression in renal transplantation: Viral diseases and chronic allograft nephropathy [J].
Salvadori, M ;
Rosati, A ;
Di Maria, L ;
Becherelli, P ;
Moscarelli, L ;
Bandini, S ;
Piperno, R ;
Larti, A ;
Gallo, M ;
Bertoni, E .
TRANSPLANTATION PROCEEDINGS, 2005, 37 (06) :2500-2501
[5]
Chronic allograft nephropathy: The major problem in long-term survival: Review of etiology and interpretation.[J].John K. Bellos;Despina N. Perrea;Dimitrios Vlachakos;Alkiviadis I. Kostakis.Transplantation Reviews.2005, 3
[6]
Potential risk factors for chronic allograft nephropathy revealed from protocoll biopsies after renal transplantation.[J].M. Mengel;W. Gwinner;J. Radermacher;H. Hiss;H. Haller;H. Kreipe;A. Schwarz.Pathology - Research and Practice.2004, 4
[7]
Predicting kidney graft failure by HLA antibodies: a prospective trial [J].
Terasaki, PI ;
Ozawa, M .
AMERICAN JOURNAL OF TRANSPLANTATION, 2004, 4 (03) :438-443
[8]
Humoral theory of transplantation [J].
Terasaki, PI .
AMERICAN JOURNAL OF TRANSPLANTATION, 2003, 3 (06) :665-673
[9]
Treatment of chronic allograft nephropathy with mycophenolate mofetil after kidney transplantation:: A Spanish Multicenter study [J].
Molina, MG ;
Serón, D ;
Del Moral, RG ;
Carrera, M ;
Sola, E ;
Ullate, PG ;
Capdevila, L ;
Gentil, MA .
TRANSPLANTATION PROCEEDINGS, 2002, 34 (01) :335-+
[10]
Calcineurin-inhibitor withdrawal: changes in arterial distensibility and endothelial function in chronic allograft nephropathy after CNI withdrawal.[J].Barbara M. Suwelack;Markus Kosch;Viola Kobelt;Helge Hohage;Ulf M.W. Gerhardt;Martin Hausberg.American Journal of Hypertension.2002, 4