肝移植术后应用无激素免疫抑制方案的探讨

Using tacrolimus, mycophenolate and senipen for no-hormone immunosuppressive therapy after liver transplantation

目的探讨肝移植术后联合应用他克莫司（FK506）、霉酚酸酯（MMF）和达利珠单抗的无激素免疫抑制方案的效果。方法根据双盲和随机原则，将60例因良性终末期肝病而进行肝移植的受者分为研究组与对照组，每组各30例。研究组采用的免疫抑制方案为：FK506＋MMF＋达利珠单抗；对照组为：FK506＋MMF＋激素。术后对受者进行长期随访，比较两组存活率及并发症等方面的差异。结果研究组受者术后1、2年存活率分别为89．3％和90．2％，对照组为70.2％和73．3％；研究组移植物1、2年存活率分别为92．4％和91．1％，对照组为75．1％和73．2％；研究组和对照组术后3个月内急性排斥反应发生率分别为20．0％和28．5％；两组的差异均无统计学意义（P〉0．05）。研究组受者伤口愈合不良、感染、高血压病、糖尿病、高胆固醇血症以及乙型肝炎复发的发生率明显低于对照组（P〈0．05）。结论肝移植术后联合应用FK506、MMF和达利珠单抗的无激素免疫抑制方案效果良好，并发症的发生率较少。

Objective To investigate the effect of using tacrolimus, mycophenolate and senipen for no-hormone immunosuppressive therapy after liver transplantation. Methods Patients with final stage liver diseases were divided into two groups by double-blind and random principle. The study group （n = 30） underwent immunosuppressive therapy for the patients after liver transplantation by using tacrolimus, mycophenolate and senipen, and the control group （n = 30） by using tacrolimus, mycophenolate and hormone. Results There was no significant diference between two groups in 1- or 2- year survival rate, graft survival rate, acute rejection incidence 3 months after operation. The incidence of intention badness and infection, hypertensive disease, diabetes, hypercholesterinemia and type B hepatitis recurrence in the study group was lower significantly than in control group. Conclusion Using tacrolimus, mycophenolate and senipen for no-hormone immunosuppressive therapy after liver transplantation has good effect with lower incidence of complications.