联合霉酚酸酯、环孢素A和泼尼松应用于肾移植患者免疫抑制治疗

Immunosuppressive therapy for renal transplant recipients with Cellcept, Cyclosporine A and Prednison

目的研究不同剂量霉酚酸酯(MMF)与环孢素A(CsA)和泼尼松(Pred)联用对肾移植患者免疫抑制作用的疗效与安全性。方法随机将120例肾移植受者分为3组,分别给予MMF2.0g/d(A组)、1.5g/d(B组)及硫唑嘌呤(Aza)100mg/d(C组)。3组患者均同时接受相似剂量的CsA和Pred。观察肾移植术后6个月内急性排斥反应的发生率、移植肾功能和药物的副作用。结果A,B,C组急性排斥反应的发生率分别为8.7%,5.6%和36.8%;A,B组消化道的副作用多见,C组的白细胞减少现象多见,其他副作用3个组的差异无显著性。术后6个月A,B组患者的血清肌酐值明显低于C组。结论不同剂量的MMF与CsA和Pred联合应用,可有效预防术后早期急性排斥反应的发生。MMF除胃肠道的副作用较多外,其他副作用未见增多。

[Objective] To investigate the immunosuppresslve effect and safety of with different doses of Cellcept （MMF）, Cyclosporine A （CsA） and Prednison （Pred） for renal transplant recipients. [Methods] 120 cadaveric renal transplant recipients were randomly divided into 3 groups, receiving MMF 2.0 g/d , CsA and Pred （group A）,. MMF 1.5 g/d, CsA and Pred （group B） and Azathioprine （Aza） 100 mg/d, CsA and Pred（greup C）respectively. The incidence of the acute renal allograft rejection, the function of the renal graft and the adverse effects were observed at the first 6 months after renal transplantation. [Results] The incidence of the acute rejection was 8.7%,5.6%, 36.8% in the groups A, B and C respectively. The frequency of diarrhea was the highest in the group A and the leukocyte decrease was the highest in the group C, and other side events were similar among the three groups. Six months after transplantation, serum creatinine level in group A and B was obviously lower than that of the group C. [Conclusions] Combined use of different dose of MMF with CsA and Pred can effectively prevent the occurrence of acute rejection after transplantation. Except for the side events of diarrhea, other MMF-induced side effects are not increased.