肝移植术后早期免疫抑制剂相关高血压的治疗

Management of early immunosuppressant-associated hypertension after liver transplantation

目的探讨肝移植术后早期免疫抑制剂相关高血压的发生及治疗。方法对 2 0 0 0年 5月至 2 0 0 2年 5月进行的 5 6例次接受肝移植手术的患者进行分析。结果肝移植术后 2周、3周、1个月最高平均收缩压分别是 (145± 15 )、(138± 9)、(133± 13)mmHg比术前明显升高 (P <0 0 1) ,术后 2周、3周最高平均舒张压分别为 (92± 14)、(90± 13)mmHg比术前有明显升高 (P <0 0 1) ,早期高血压发生率分别是 :术后两周 70 % ,1个月 6 6 %。术后 1个月时服用环孢霉素A组和FK5 0 6组高血压发生率分别为 73 % (30 41)、33% (3 9) ,两组相比差异有显著意义 (P <0 0 5 ,χ2 =5 2 2 )。两组术后 1个月时激素总量、血BUN值、血肌酐值差异无显著意义。结论肝移植术后高血压有较高发生率 ,主要由术后服用的免疫抑制剂引起 ,治疗以口服钙离子拮抗剂为主。

ObjectiveTo manage the early immunosuppressant-associated hypertention in liver transplantation patients. MethodsFifty-six liver transplantations were performed from May 2000 to May 2002, their clinical feature (data of blood pressure and treatment) were analysed. ResultThe incidence of hypertension after liver transplantation was 70% in 2 weeks, 66% in one month. The incidence in cyclosporine group and FK506 group was 73% (31/40) and 33%(3/9) respectively(P<0.05, χ 2=5.22). The total dosage of steroids, serum BUN and creatinine concentration were not significantly different between the two groups. ConclusionImmunosuppressant-associated hypertension is a ubiquitous problem among early liver transplantation patients, which is usually amenable to calcium-channel blockers.