熊去氧胆酸辅助预防肝移植排斥的临床研究

Clinical research of ursodeoxycholic acid as adjuvant treatment to prevent liver transplant rejection

目的研究熊去氧胆酸(优思弗)对原位肝移植的急性排斥反应、感染率、住院治疗时间及90d存活率的影响。方法总结105例肝移植患者的临床资料,优思弗治疗组78例,未使用优思弗27例为对照组;所有患者均使用他克莫司(FK506)或皮质类固醇作为免疫抑制剂。结果治疗组急性排斥反应多次发作的病例数显著小于对照组(2:7,P=0.01),严重的细菌感染率明显降低(3%:33%,P=0.01),住院时间明显缩短(34d:47d,P=0.03)和更高的90d存活率(97%:85%,P=0.04)。结论基于FK506的免疫抑制疗法中加入优思弗,可减少肝移植急性排斥反应的发作次数,值得推荐。

Objctive To investigate ursodeoxycholic acid （Ursofalk） efficacy in acute rejection following orthotopic liver transplantation and its effects on complication such as infections,length of hospital stay and 90 d survival rate. Methods A total of 105 cases of orthotopic liver transplantation were reviewed, 78 in ursodeoxycholic acid treatment group, 27 in the control group. All patients were treated with FK506 or ghcocorticoids. Results In the treatment group fewer patients have multiple episodes of acute recjection （2 ： 7,P=0.01）, lower incidence of bacterial infections （3% ： 33%,P=0.01）, shorter hospital stay （34 d ： 47 d,P=0.03） and better 90 d survival （97% ： 85%,P=0.04） than those in the control group. Conclusion The addiction of ursodeoxycholic acid to immunosuppressive regimen based on FK506 can significantly reduce multiple episodes of acute rejection of orehotopic liver transplantation.