肾移植术后爬行肌酐的综合治疗

Combined treatment of crawling creatinine following renal transplantation

目的研究肾移植术后爬行肌酐的治疗对策及效果。方法对肾移植术后的20例爬行肌酐患者应用半量甲基泼尼松龙冲击治疗、更改免疫抑制药、应用活血化瘀药物、调整抗高血压药等治疗,观察2周后及3个月后的肌酐下降水平。结果 2周后18例患者血肌酐下降至平时水平,2例患者血肌酐水平停止爬行,维持在血肌酐爬行之前的水平;3个月后18例血肌酐下降的患者中14例血肌酐维持稳定,4例再次出现爬行肌酐;2例血肌酐水平停止爬行的患者血肌酐维持原有水平。结论肾移植术后爬行肌酐治疗关键在于及时发现、及时治疗,对于无穿刺病理活检条件的医院,综合治疗是一种较好的方法。

Objective To study the therapeutic strategy of crawling creatinine after kidney transplantation and its effect. Methods The 20 patients received renal transplantation,their crawling creatinine was treated with half the amount methylprednisolone pulse therapy,changing the immunosuppressant drugs,and using promoting blood circulation,adjusting antihypertensive therapy;after two weeks and three months the creatinine levels drop was observed. Results Among the 20 cases 18 after two weeks down to normal levels of serum creatinine,also two cases to stop crawling and maintain the level of serum creatinine before crawling;after three months in the 18 cases with serum creatinine decreased to normal serum level maintained stability ,4 cases occurred again crawling;the 2 cases of serum creatinine levels stopped crawling maintained their original level. Conclusion The key of treatment of crawling creatinine following renal transplantation is it timely detected and timely treated;for the hospitals without the conditions for performing puncture biopsy,comprehensive treatment is a better approach.