摘要
目的探讨前列地尔应用于肾移植术后患者的治疗反应,指导钙调神经蛋白抑制剂(calcineurin inhibitor,CNI)类药物减量的临床应用价值。方法回顾性分析42例同种异体肾移植术后>1年,肌酐140～250 mmol/L,环孢素或他克莫司血药浓度正常,因肌酐升高于2010年6月至2011年5月在我科住院患者,应用前列地尔治疗效果指导CNI类药物减量,改善移植肾功能的有效率。结果 42例患者经前列地尔治疗后肌酐均有不同程度的下降,其中38例肌酐下降>20%,平均下降率为23.8%,减少CNI类药物用量后,肌酐稳定出院;2例肌酐分别下降18.7%、14.5%,CNI减药后发生急性排斥反应;2例肌酐分别下降11.9%、16.5%,免疫抑制方案未予调整,停用前列地尔后肌酐稳定出院;前列地尔治疗反应指导CNI类药物减量改善移植肾功能的有效率为95.0%。结论利用前列地尔治疗反应指导CNI类药物减量是一种简便、有效的方法,弥补了血药浓度监测调整CNI类药物用量存在局限性的不足,在临床上有一定的实用价值。
Objective To explore the clinical value of the application of alprostadil to direct the reduction of CNI（calcineurin inhibitor）dosage in renal transplant recipients.Methods Clinical data of 42 cases of renal transplant recipients over 1 year with appropriate CNI blood concentration and serum creatinine（Scr） level from 140 to 250mmol/L in our department from June 2010 to May 2011 experienced elevation of Scr earlier were retrospectively analyzed.The efficiency of the method that alprostadil was used to direct the reduction of CNI dosage was observed.Results After the treatment of alprostadil,Scr decreased in all the 42 patients at different degree with 38 cases decreasing rate20%,average at 23.8%,discharged from hospital with stable Scr level after reduction of CNI dosage.Acute rejection occurred in 2 cases after the reduction of CNI dosage with the Scr decreasing rate of 11.9% and 16.5%.The Scr decreasing rates of the other 2 cases were 18.7% and 14.5% who discharged from hospital with stable Scr level but adjustment of immunosuppressant dosage.The efficiency of the method that the reduction of CNI dosage was directed by Scr decreasing rate following the treatment of alprostadil to protect the graft function was 95.0%.Conclusions The application of alprostadil to direct the reduction of CNI dosage in renal transplant recipients is a simple and efficient method with high clinical practical value which can improve the restriction of CNI blood concentration monitoring.
出处
《实用医院临床杂志》
2011年第6期30-32,共3页
Practical Journal of Clinical Medicine
