摘要
目的探讨无皮质激素的免疫抑制方案对原位肝移植术后近期急性排斥反应发生率的影响。方法采用随机数字表法将186例肝移植受者分为两组。无皮质激素组（研究组）术后均采用他克莫司（Tac）[或环孢素A（CsA）]＋吗替麦考酚酯（MMF）的免疫抑制方案，未使用皮质激素；有皮质激素组（对照组）术后均采用Tac（或CsA）＋MMF＋皮质激素的三联免疫抑制方案。观察术后6个月内两组间急性排斥反应发生率的差异。急性排斥反应的诊断参照Banff标准。结果两组受者间性别、年龄、原发病、Child—Pugh评分、终末期肝病模型（MELD）评分、手术时间、术中出血量、输注红细胞悬液及供肝热、冷缺血时间等基本资料的比较，差异均无统计学意义（P〉0．05）。观察期内，研究组和对照组接受移植肝穿刺活检各9例次，诊断为急性排斥反应者分别为5和4例，发生率分别为5．3%（5／94）和4．4％（4／92），两组间比较，差异有统计学意义（P〈0．05）。结论肝移植术后采用无皮质激素的免疫抑制方案不会增加近期（半年内）急性排斥反应的发生率。
Objective To investigate the short-term acute rejection incidence of the recipients under the steroid-free immunosuppressive therapy after liver transplantation. Methods This retrospective study included 186 patients who were divided into two groups by random number table. The patients in no-steroid group （the study group, n = 94） received tacrolimus （Tac） with mycophemolate rnofetil （MMF） or cyclosporine with MMF, and those in the steroid group （the control group, n = 92） received the aforementioned immunosuppressive therapy combined with steroids. The acute rejection incidence was analyzed during six months post-transplantation. Results There was no significant difference in the gender, age, indication for transplantation, Child-Pugh score, MELD score, operating time, bleeding and transfusion volume during the operation, warm ischemia time and cold ischemia time between the two groups （P〉0. 05）. Liver biopsy was done on 9 cases of each group. The acute rejection incidence had no significant difference between the study group and the control group （5/94 vs 4/92, 5. 30% vs 4. 4%%, P〉0. 05）. Conclusion The steroid-free immunosuppressive therapy after liver transplantation did not increase the short-term acute rejection incidence.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2012年第4期217-219,共3页
Chinese Journal of Organ Transplantation
关键词
肝移植
免疫抑制剂
糖皮质激素类
移植物排斥
Liver transplantation
Immunosuppressive agents
Glucocorticoids
Graft rejection
