环孢菌素A和1,2 5(OH)2D3防治实验性自身免疫性甲状腺炎的研究

将猪的甲状腺球蛋白（pTG)100μg/只分别于第0d,第14d皮下注入CBA小鼠体内，制作实验性自身免疫性甲状腺炎（EAT）的动物模型。免免疫干预组从0－28d，治疗组从10－38d单独或者联合应用环孢菌素A（CsA,10mg/kg)灌胃和（或）1,25(OH)2D3(0.2μg/kg）腹腔注射，pTG免疫后第28d，第38d处死小鼠，取甲状腺组织作病理学检查，并检测血清中猪的甲状腺球蛋白抗体（pTGAb)、猪的甲状腺微粒体抗体（pTMAb)。免疫干预组和治疗组联合应用小剂量CsA和1，25（OH）2D3分别使EAT发病率降低44．44％和37．50％。严重病例分别降低71．43％和60．32％，免疫干预组的血清pTGAb,pTMAb的值均降低。提示：小剂量免疫抑制剂CsA和1，25（OH）2D2联合防治EAT有效，并具有协同作用。     

环孢菌素A治疗难治性Evans综合征的疗效观察

Evans综合征是一种自身免疫性溶血性贫血和血小板减少性紫癜同时或相继发生的综合征,发病机制与自身免疫功能紊乱有关,用激素治疗有效,但有相当一部分患者用激素治疗效果差,且副反应大,难以忍受.为进一步探讨对Evans综合征的治疗,我们应用环孢菌素A(CsA)治疗难治性Evans综合征患者12例.现报告如下.     

环孢菌素A引起的牙龈增生组织学超微结构观察

Rate itschak-P luss EM首次报告环孢菌素A可引起药物性龈增生[1]。本文观察环孢菌素性龈增生的病理学表现和可能的病理机制。1材料和方法1.1病例来源对14例(男10例,女4例)肾移植术后0.5~5年,全身情况良好,肾功能稳定,服用环孢菌素A并有牙龈增生的病例,作牙及牙龈状况评估。在基础治疗后,征得患者知情同意,于局麻下切除局部增生牙龈。1.2制作光镜切片增生牙龈组织立即用100 mL /L福尔马林固定,常规石蜡包埋,HE染色,光镜观察。1.3制作电镜切片5例增生牙龈组织同时作电镜切片。将切除的牙龈组织切成1 mm×1 mm×1 mm,立即置于4℃30 mL /L…     

环胞素A治疗获得性单纯性无巨核性血小板减少性紫癜4例分析

对我院近2a来使用环胞素A治疗获得性单纯性无巨核性血小板减少性紫癜4例分析如下。     

低蛋白饮食对环孢素A肾病大鼠肾间质纤维化的作用

Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.     

HLA-DRB1*1501等位基因与环孢菌素A治疗再生障碍性贫血疗效的关系

近年来日本学者发现日本的再生障碍性贫血(AA)患者HLA—DRB1 *1501等位基因的频率较普通人群高，对环孢菌素A(CSA)治疗敏感且具有依赖性。由于HIA各等位基因存在较大的种族和地域差异，在汉族人群中是否可以据此预测CsA对AA的疗效，目前报道较少。我们用PCR-SSO及PCR-SSP技术检测山东日照地区汉族AA患者中该等位基因，观察其与CsA疗效的关系。     

环孢菌素A治疗皮肌炎合并问质性肺炎1例

1 临床资料 患者男，55岁。因面部、颈前水肿性红斑伴四肢肌肉酸痛、无力1年余就诊。曾在外院以“皮肌炎”，予口服强的松70mg，1次／d，2周后症状缓解，减量至6Omg，1次／d，以后每2周减量10mg，减至30mg，1次／d时持续服用3个月，病情稳定，强的松减至20mg，1次／d。6个月前，患者自行停用强的松。同年4月上述症状再次出现，遂来本科就诊。体检：T38．7℃，P120次／rain。     

环孢素A对肾移植术后病人血脂的影响

目的 :观察环孢素A对肾移植术后患者血脂的影响。方法 :对 60名肾移植术后患者 ,测定其环孢素、胆固醇及甘油三酯水平 ,按不同的环孢菌素A浓度将患者进行分组 ,并将术前与术后的水平进行比较。结果 :肾移植前后 ,胆固醇和甘油三酯水平改变显著 ,有统计学意义 (P <0 .0 5)。结论 :服用环孢素A可能是导致肾移植术后高脂血症的原因之一。     

环孢菌素A治疗再生障碍性贫血的护理

环孢菌素A(CsA)具有双向调节免疫的药理作用 ,近年来这种功能在临床上越来越受到重视。我科自 1 997年以来用CsA作为免疫抑制剂治疗AA5 0例。现将护理方法总结如下。1用药过程中的护理1 .1口服胶囊应贮存在 3 0℃以下 ,不应用时不宜打开包装。1 .2指导患者注意休息 ,不去公共场所 ,不串病房 ,严禁有呼吸道疾患的人前往探视 ,以防交叉感染。1 .3指导患者注意个人卫生 ,勤剪指甲 ,及时更换内衣内裤 ,饭后用洗必肽溶液漱口 ,保持口腔清洁。1 .4严密观察病人的出血倾向 ,首先应注意观察皮肤粘膜 ,是否有出血点及瘀斑 ,尤其注意口腔粘膜是否有…