他克莫司和环孢素A对肾移植术后患者肝功能影响的临床比较观察

目的:研究和比较他克莫司（FK506）以及环孢素A（CsA)对肾移植术后患者肝功能的影响。方法：将肾移植术后患者随机分为FK506组和CsA组，FK506组8例，CsA组26例。CsA组中出现肝功能异常的6例患者用FK506进行替换治疗。两组均联合应用霉酚酸酯（MMF）和泼尼松（Pred)。结果：观察6个月，FK506组和CsA组中急性排斥的发生率差异 不显著；FK506组中未发现肝功能异常患者，CsA组中有6例患者肝功能异常；肝功能异常的6例患者用FK506替换CsA后，总胆红素（TBIL）、直接胆红素（DBIL）、丙氨酸转氨酶（ALT）相继转为正常。结论：FK506免疫抑制剂效果与CsA相似，但对肝功能影响甚微，适合应用于术前有肝功损害或术后应用CsA后出现肝功能异常倾向的患者。

Effect of FK506 and CsA on hepatic function of renal transplant recipients

ObjectiveTo investigate the effect of FK506 and CsA comparatively on hepatic function of renal transplant recipients. Methods FK506 and CsA were used respectively as a post operative immunosuppressant for 8 and 26 cases of renal transplantation. In the CsA treated group, 6 cases of hepatic dysfunction were conversed to FK506. Both two groups took MMF and prednisone. Results During the period of observation, there was no significant difference between FK506 and CsA in acute rejection incidence. Comparing to FK506 group with no case of hepatic dysfunction, hepatic dysfunction occurred in 6 cases who conversed to FK506, and liver function returned normal gradually in the CsA group. Conclusion It is effective and safe to substitute CsA by FK506 combined with MMF in renal transplant recipients with hepatic dysfunction after renal transplantation.