雷公藤醋酸乙酯提取物在肾移植应用中的临床研究

CLINICAL OBSERVATION OF ETHYLACETATEEXTRACT OF TRIPTERYGIUM WILFORDII (TWH)IN HUMAN CADAVERIC RENAL TRANSPLANTATION

本研究在动物实验的基础上将雷公藤醋酸乙酯提取物用于同种人体肾移植术后患者共８３例，随机分３组：①对照组，术后每日用环抱素Ａ８ｍｇ／ｋｇ，强的松０．４～０．６ｍｇ／ｋｇ；②ＴＷＨ组，术后每日服用雷公藤醋酸乙酯提取物１．８±０．６ｍｇ／ｋｇ，环孢素Ａ８ｍｇ／ｋｇ，强的松０．４～０．６ｍｇ／ｋｇ；③Ａｚａ组，术后每日服用硫唑嘌呤１．５±０．５ｍｇ／ｋｇ，环孢素Ａ８ｍｇ／ｋｇ，强的松０．４～０．６ｍｇ／ｋｇ。采用常规检查、彩色多普勒超声仪及淋巴细胞化学发光，进行３个月的临床监测。观察结果显示：①各组术后移植肾功能恢复时间无显著差异，术后肾功能状态以ＴＷＨ组最佳；②术后急性排斥反应发生率以ＴＷＨ组最低；③术后感染率及血白细胞减少发生率ＴＷＨ组较Ａｍ组低，但较对照组为高，肝损害发生率ＴＷＨ组与ＡＺａ组未显示出差异，但两组肝损害发生率较对照组高。初步结论是：雷公藤醋酸乙酯提取物可以在同种异体肾移植中应用，与环孢素及激素联合用药，抗排斥效果较相应的硫唑嘌呤三联用药方案为佳，副作用小，雷公藤酯酸乙酯提取物在同种人体肾移植中应用，总体作用优于硫唑嘌呤。

In this paper , the application of ethylacetate extract of TWH to human cada-veric renal transplantation was investigated. The recipients were randomly divided into threegroups:①Control group , 30 cases of the recipients were treated with CsA 8 mg/kg. d andpred.0.6～0.4mg/ kg·d②TWH group, 25 cases with tablets of ethylacetate extract oftripterygium wilfordii 1.8～ 6mg/kg.d;CsA 8mg/kg. d and pred 0.6～0.4mg/kg·d③Aza group,30 cases with Aza 1.5±0.5mg/kg·d.CsA 8 mg/kg.d.All recipients were ob-served for three months.The results showed that :(A)In the three groups there was no differince in the time ofrecovery of the allograft's function after transplantation ,the renal function of the recipientsin TWH group was supperior to that of others;(B)The incidence of the acute allograft rejec-tion of the recipients in TWH group was the lowest in the three groups;The incidence ofinfection of the recipients in TWH group was lower than that of Azas and the decrese ofWBC was mild;the incidence of the liver impairment of the recipients in TWH group corre-sponded to that in Azas , but higher than that in controls,It suggested that TWH can be usedin human cadaveric renal transplantation , and is supperior to Aza.