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3种免疫抑制剂替换方案治疗肾移植术后“爬行肌酐”的疗效观察 被引量：4

Three Immunosuppressant Conversion Protocols in Kidney Transplant Recipients with Creeping Creatinine
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摘要 目的:观察3种免疫抑制剂替换方案治疗肾移植术后"爬行肌酐"患者的疗效。方法:回顾性分析1992年12月～2005年11月间53例术后出现"爬行肌酐"肾移植受者的临床资料,按出现"爬行肌酐"后采用的替换治疗方案分为FK506组(n=24)、MMF组(n=18)和SRL组(n=11),观察治疗前后的移植肾功能及血压、血糖、血脂等的变化,并比较随访12个月的情况。结果:FK506组治疗后移植肾功能较前明显好转,血肌酐下降明显(P<0.05),同时降低了血脂水平,减少降脂药物及抗高血压药物的使用,替换后的血糖升高不明显;MMF组治疗后可以延缓大部分病例的移植肾功能减退,降低血脂水平,减少抗高血压药物的使用以及肝脏、骨髓毒性;SRL组治疗后亦可以延缓部分病例的移植肾功能恶化,但可引起或加重高脂血症及贫血。结论:对肾移植术后"爬行肌酐"患者采用的3种免疫抑制剂替换方案都可以有效地改善或稳定移植肾功能。 Objective： To investigate the effect of three immunosuppressant conversion protocols on reversing creeping creatinine in kidney transplant recipients. Methods：A retrospective study was performed in 53 kidney recipients with creeping creatinine from December, 1992 to November, 2005 in our transplantation center. According to the conversion protocols, the patients were divided into FK506 group （ n = 24） ,MMF group （ n = 18） and SRL group （ n = 11 ）. Graft function, blood pressure, blood glucose and lipid profiles were monitored during the 12 - month follow- up intervals. Results： In FK506 group, there was a significant improvement in GFR and lipid profiles while less lipid - lowering and antihypertensive drugs were required after conversion. In MMF group, the graft function of most recipients was stable while decreasing the level of lipid profiles, reducing the dose of antihypertensive drugs, and lessening hepatotoxicity and myelosuppression were observed after conversion. In SRL group, the aggravation of some recipients＇ graft function was delayed but the incidence of hyperlipidemia and anemia was higher after conversion. Conclusion： These t conversion protocols can improve or stabilize the graft function in kidney transplant recipients with creeping creatinine.
作者 倪晓洁 郑少玲 杨亦荣 夏鹏 陈必成 吴存造 孙贤斌 蔡勇
机构地区 温州医学院附属第一医院移植中心
出处 《中国中西医结合肾病杂志》 2008年第11期974-977,共4页 Chinese Journal of Integrated Traditional and Western Nephrology
关键词 肾移植 爬行肌酐 钙调神经抑制剂 西罗莫司 霉酚酸酯 Kidney transplantation Creeping creatinine Calcineurininhibitor Sirolimus Mycophenolatemofetil
分类号 R699.2 [医药卫生—泌尿科学] R979.5 [医药卫生—药品]
  • 相关文献

参考文献13

  • 1Dudley C, Pohanka E, Riad H, et al. Mycophenolate mofetil substitution for cyclosporinc a in renal transplant recipients with chronic progressive allograft dysfunction: the Creeping Creatinine Study. Transplantation, 2005,79 (4) : 466 - 475.
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  • 3Martins L, Ventttra A, Branco A, et al. Cyclosporine versus tacrolimus in kidney transplantation: are there differences in Nephrotoxicity? Transplantation Proc, 2004, 36 (4): 877 - 879.
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  • 5柏宏伟,石炳毅,钱叶勇,那彦群,常京元,周文强,王亚炜.用他克莫司替换环孢素A预防和治疗肾移植后慢性移植肾肾病[J].中华器官移植杂志,2006,27(6):356-358. 被引量：8
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二级参考文献18

  • 1Shishido S, Asanuma H, Nakai H, et al. The impact of repeated subclinical acute rejection on the progression of chronic allograft nephropathy. J Am Soc Nephrol, 2003, 14:1046-1052.
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  • 3Martins L,Ventura A, Braneo A, et al. Cyclosporine versus tacrolimus in kidney transplantation: are there differencesin nephrotoxicity? Transplant Proc, 2004, 36: 877-879.
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  • 10Ferraris JR, Tambutti ML, Cardoni RL, et al. Conversion from cyclosporine A to tacrolimus in pediatric kidney transplantrecipients with chronic rejection: changes in the immune responses.Transplantation, 2004, 77:532-537.

共引文献7

同被引文献68

  • 1王长希,郑克立,赵亮,陈立中,费继光,刘龙山.西罗莫司用于肾移植患者的临床前瞻性研究[J].世界临床药物,2005,26(1):55-57. 被引量：5
  • 2Morris RE. J eiser BM1 Identification of a new pharmacologic action for an old compound. Med Sci Res, 1989,17(4) : 6091.
  • 3Lehmkuhl H, Ross H, Eisen H, et al. Everolimus (certican)in heart transplantation: optimizing renal functiont hrough minimizing cyclosporine exposure. Transplant Proc, 2005,37 ( 10 ) : 41451.
  • 4Chapman JR. Chronic allograft dysfunction. J Am Soc Nephrol, 2005,16(10) :3015 - 3026.
  • 5Dancey JE. Clinical development of mammalian target of rapamycin inhibitors. Hematol Oncol Clin North Am, 2002, 16 (5):1101 - 1114.
  • 6Bumbea V, Kamar N, Ribes D, et al. Long - term results in renal transplant patients with allograft dysfunction after switching from calcineurin inhihitors to sirolimus. Nephrol Dial Transplant, 2005,20(11 ) : 2517 - 2523.
  • 7Ruiz JC, Campistol JM, Sdnchez- Fructuoso A, et al. Increase of proteinuria after conversion from calcineurin inhibitor to sirolimus-- based treatment in kidney transplant patients with chronic allograft dysfunction. Nephrol Dial Transplant, 2006,21 (11) : 3252 - 3257.
  • 8Coombes JD, Mreich E, Liddle C, et al. Rapamyein worsens renal function and intratubular cast formation in protein overload nephropathy. Kidney Int, 2005,68 (6) : 2599 - 2607.
  • 9Castello IB. Hyperlipidemia: a risk factor for chronic allograft dysfunction. Kidney Int Suppl, 2002, (80) : 73 - 77.
  • 10Formica RN, Lorber KM, Friedman AL, et al. Sirolimus - based immuno- suppression with reduce dose cyclosporine or tacrolimus after renal transplant. Transplant Proc, 2003,35 (3 suppl) : s95 - s98.

引证文献4

二级引证文献9

中国中西医结合肾病杂志
2008年 第11期

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