[1]刘宏,赵洪雯,李敛,等.肾移植术后雷帕霉素初始治疗疗效的初步分析[J].第三军医大学学报,2008,30(07):644-646.
 LIU Hong,ZHAO Hong-wen,LI Lian,et al.Initial use of rapamycin after kidney transplantation[J].J Third Mil Med Univ,2008,30(07):644-646.
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肾移植术后雷帕霉素初始治疗疗效的初步分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
30卷
期数:
2008年第07期
页码:
644-646
栏目:
论著
出版日期:
2008-04-15

文章信息/Info

Title:
Initial use of rapamycin after kidney transplantation
作者:
刘宏赵洪雯李敛余荣杰吴雄飞
第三军医大学西南医院肾科
Author(s):
LIU Hong ZHAO Hong-wen LI Lian YU Rong-jie WU Xiong-fei
Department of Kidney, Southwest Hospital, Third Military Medical University
关键词:
抗胸腺淋巴细胞免疫球蛋白雷帕霉素肾移植
Keywords:
antithymocyte globulin rapamycin kidney transplantation
分类号:
R392.8; R699.2; R979.5
文献标志码:
A
摘要:
目的 观察ATG+雷帕霉素初始治疗对肾移植的疗效和安全性。 方法 选取我院2006年3月至2007年7月收治的同种异体肾移植患者38例,其中雷帕霉素组18例,对照组20例。雷帕霉素组采用即复宁术前、术后24 h各50 mg 诱导,术后3 d雷帕霉素+骁悉+激素初始治疗;对照组采用硫唑嘌呤诱导,术后采用激素+环孢素(或普乐可复)+骁悉三联免疫抑制治疗,观察两组患者术后肝功能、血肌酐、血脂、C反应蛋白、血色素及术后并发症发生。 结果 术后3周两组患者肝功能、血肌酐、C反应蛋白、血色素指标无明显差异,雷帕霉素组血肌酐恢复正常时间显著早于对照组,血甘油三酯、胆固醇显著高于对照组;雷帕霉素组出现切口愈合延迟2例(2/18),血小板减少1例(1/18),对照组出现急性排斥反应3例(3/20),移植肾功能迟延恢复4例(4/20)。 结论 ATG诱导+雷帕霉素用于肾移植后的初始治疗可显著减少移植后急性排斥和移植肾功能迟延恢复的发生率,安全性较好。
Abstract:
Objective To evaluate the therapeutic effects and safety of initial use of antithymocyte globulin (ATG) and rapamycin during the early stage after kidney transplantation.  Methods Thirty-eight patients were enrolled during 2006 to 2007, 18 in rapamycin group and 20 in control group. In rapamycin group, 50 mg ATG was used 24 h before and 24 h after kidney transplantation, and triple immunosuppressive therapy (rapamycin+MMF+steroid) was applied 3 d after the operation; Control group was induced by azathioprine, and treated by triple immunosuppressive therapy [steroid+cyclosporine (or Prograf)+ MMF]. Liver function, serum creatinine, blood lipid, C reactive protein, and Hb were measured and the postoperative complications were observed.  Results There was no significant difference in liver function, serum creatinine, C reactive protein, Hb level between 2 groups 3 weeks after kidney transplantation. Serum creatinine decreased more rapidly in rapamycin group, while triglyceride and cholesterol increased. In rapamycin group, delayed wound healing occurred in 2 patients and thrombocytopenia in 1 patient. In contrast, acute rejection occurred in 3 patients and delayed graft function was found in 4 patients in control group.  Conclusion ATG induction and initial use of rapamycin is safe and can obviously decrease the incidence of acute rejection and delayed graft function after kidney transplantation.

参考文献/References:

刘宏,赵洪雯,李敛,等. 肾移植术后雷帕霉素初始治疗疗效的初步分析[J]. 第三军医大学学报,2008,30(7):644-646.

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更新日期/Last Update: 2008-04-18