摘要
目的 观察肝移植术后应用普乐可复(FK5 0 6 )进行免疫抑制治疗的临床效果和毒副作用。方法 36例患者肝移植术后使用以FK5 0 6为基础的三联免疫抑制方案 ,即FK5 0 6 +霉酚酸酯(MMF) +皮质激素 ,其中 2 4例采用赛尼哌抗体诱导疗法。结果 36例中发生急性排斥反应 3例 ,经甲泼尼龙 (MP)和OKT3单克隆抗体治疗后逆转。FK5 0 6的副作用主要有神经系统功能紊乱 (40 0 %)、高血压(13 3%)、血糖升高(2 6 7%)及肝功能不良(6 7%)。结论 普乐可复是一种强效的免疫抑制剂。由于治疗窗狭窄 ,它的用药剂量应根据药物谷值浓度进行调整 ,而且用药要个体化。
Objective To observe the therapeutic effects and side-effects of tacrolimus (FK506) in the recipients who had undergone liver transplantation, and summarize the clinical experience of its use. Method The clinical data of 36 recipients of allogeneic liver transplants followed by tacrolimus-based anticoagulant regimen were retrospectively analyzed. After liver transplantation, all the recipients received the triple-drug immunosuppressive protocol, including tacrolimus as the basic drug, mycophenolat-mofetil (MMF), and prednisone. Twenty-four of 36 cases received Zenapax as an antibody induction therapy. Results Acute rejection occurred in 3 of 36 cases. After the use of methylprednisolone and OKT3, acute rejection was reversed. The main side-effects of tacrolimus were nervous system disturbance(40.0%), hypertension(13.3%), hyperglycemia(26.7%), and liver dysfunction(6.7%). Conclusion Tacrolimus is a safe and potent immunosuppressive agent, which can decrease the incidence of rejection in liver transplant recipients. The dosage of tacrolimus should be adjusted according to trough level with in the therapeutic window. The timely and appropriate adjustment of the immunosuppressive strategy is essential for the recipient and graft survival. Meanwhile, it is emphasized that the regime should be individualized. [HS(1*2/3]
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2003年第10期859-860,共2页
Medical Journal of Chinese People's Liberation Army
基金
全军医学科研"十五"计划重大项目基金资助课题 (编号 0 1Z0 97)
关键词
肝移植
免疫抑制剂
移植物排斥
药物毒性
liver transplantation
immunosuppressive agents
graft rejection
drug toxicity
