肾移植术后不同剂型霉酚酸酯联合应用的研究

Study of combined application of different forms of mycophenolate mofetil after renal transplantation

目的 研究不同剂型霉酚酸酯联合环孢素和类固醇皮质激素预防肾移植后急性排斥反应的疗效和安全性。方法 选择 2 8例首次接受肾移植的成年患者 ,手术后给予霉酚酸酯、环孢素和类固醇皮质激素联合治疗。霉酚酸酯采用 2种剂型序贯给药 ,静脉制剂 1.0 g静脉注射 2次 /d ,连续使用 7d ,随后改为 1.0g 2次 /d口服至 3个月。在研究的第 1,7,14天及第 1,2 ,3个月进行临床和实验室评价 ,观察肾移植后 3个月内急性排斥反应和临床不良反应的发生率、程度。结果 2 8例均完成了 3个月的临床试验 ,全部随访至今。人 /肾均存活 ,肾功能正常。急性排斥反应发生 1例 ,不良反应 7例 ,其中 2例不良反应与外科手术有关。结论 不同剂型霉酚酸酯联合环孢素和类固醇皮质激素可以预防肾移植急性排斥反应 。

Objective It is to study the curative effect and safety of different forms of mycophenolate mofetil combined with cyclosporine and steroid cortex hormone on preventing acute rejection after renal transplantation.Methods Twenty-eight adult patients who first accepted renal transplantation were selected. Combined application of mycophenolate mofetil, cyclosporine and steroid cortex hormone were given after operation. Mycophenolate mofetil 1.0 g intravenous injection were given twice a day during the first seven days and then changed to 1.0 g taken orally twice a day until three months. Clinical and laboratory evaluation was progressed on the first, seventh and fourteenth days and the first, second and third months. Acute rejection and clinical untoward reaction rates and degrees were observed in three months after renal transplantation.Results Twenty-eight cases were all finished clinic examination and all followed up so far. Patients and kidneys were all survived, and renal function was normal. One case of acute rejection and seven cases of untoward reaction were found in the study. Two cases of untoward reaction were related to surgical in the seven cases.Conclusion Different forms of mycophenolate mofetil combined with cyclosporine and steroid cortex hormone can prevent acute rejection after renal transplantation and has better efficacy and safety.