两种包含他克莫司的免疫抑制方案在肾移植中的应用体会

The comparison of two immunosuppression schemes containing tacrolimus in renal transplant recipients

目的 探讨适合中国人的他克莫司 (FK50 6)剂量。方法 对 8例使用高剂量FK50 6(0 .2mg·kg- 1 ·d- 1 )方案肾移植受者 (A组 )及 34例使用低剂量FK50 6(0 .1mg·kg- 1 ·d- 1 )受者 (B组 )术后早期血肌酐、排斥反应发生率及免疫抑制剂的不良反应进行比较。结果 A、B两组术后 2个月血肌酐水平的差异无显著性 (P >0 .0 5) ;A组半年内未见急性排斥反应发生 ;B组有 1例因血中FK50 6的浓度偏低而发生急性排斥反应 ,2例肾组织活检提示肾小管炎 ;两个组在随访期内均未见严重感染发生 ;药物的不良反应B组较少、较轻。结论 应用低剂量FK50 6组成的免疫抑制方案 ,在降低药物毒副作用的同时 。

Objective To compare the effect of two immunosuppression schemes containing tacrolimus (FK506) in renal transplant recipients. Methods The average serum creatinine level,incidence of acute rejection and side effects of FK506 were compared between high dose ( 0.2?mg/kg each day) FK506 group (group A, n =8) and low dose ( 0.1?mg/kg each day) FK506 group (group B, n =34). Results There was no significant difference in serum creatinine level 2 months after operation between groups A and B ( P > 0.05 ).In the group A,no acute rejection occurred with 6 months.In the group B,one case was suffered from acute rejection due a low dose of FK506 and renal biopsy revealed 2 cases of boun dary tubulitis. During a follow up period,no serious infection was found in the two groups. The incidence of the side effects of FK506 were lower in group B than in group A. Conclusion Low dose FK506 scheme has no influence on the effectiveness besides decreasing the side effects of FK506.