心脏移植术后的免疫抑制治疗

Immunosuppressive therapy following orthotopic heart transplantation

目的 :探讨原位心脏移植术后免疫抑制经验 .方法 :2 0 0 0 0 1 / 2 0 0 3 1 0施行 2 6例原位心脏移植手术 ,术后1 7例采用他克莫司 (FK5 0 6 )、霉酚酸酯 (MMF)及泼尼松组成的三联疗法进行免疫抑制治疗 ,9例采用环孢素 A(CsA)、霉酚酸酯 (MMF)及泼尼松三联疗法进行免疫抑制治疗 .结果 :死亡 3例 ,存活 2 3例 ,生活质量良好 ,其中 6例发生了 1 1次急性排异反应 ,经冲击治疗后逆转 .但同时出现一些药物副作用 ,如肾功能损害、高血压、高血糖等 .结论 :心脏移植术后采用FK5 0 6 ,MMF及泼尼松新三联或CsA、MMF及泼尼松三联免疫抑制治疗效果良好 。

AIM: To investigate the therapeutic efficacy and to summarize the experience of immunosuppressive therapy following orthotopic heart transplantation. METHODS: Twenty six cases of othotopic heart transplantation were performed from January 2000 to October 2003. Of them, 17 cases received triple therapy of tacrolimus, mycophenolate mofetil and prednisone postoperation and 9 cases received triple therapy of cyclosporine A, mycophenolate mofetil and prednisone psotoperation. RESULTS: Among the 26 cases, 23 patients survived with good quality of life, 6 patients suffered from 11 episodes of acute rejection, which were reversed after impacting therapy. The main side effects were abnormal renal function, hypertension and hyperglycemia. CONCLUSION: Both the triple therapy of tacrolimus, mycophenolate mofetil and prednisone and the triple therapy of cyclosporine A, mycophenolate mofetil and prednisone after orthotopic heart transplantation are of fairly good therapeutic efficacy. But the side effects of drugs should be monitored closely.