前列地尔促进肾移植术后早期恢复的临床研究

目的探讨前列地尔能否促进肾移植患者术后康复。方法2003年1月至2006年8月,对298例肾移植受者术中及术后2周内每天静脉滴注前列地尔50μg,与同期内287例未使用前列地尔的肾移植受者进行对比,比较两组术后尿量、血肌酐(SCr)、肌酐清除率(Ccr)、血压、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、B超下移植肾血流阻力指数以及两组肾功能恢复延迟(DGF)和急性排斥反应的发生率。结果应用前列地尔的患者术后尿量和Ccr均明显大于对照组;高血压、ALT和(或)AST异常升高病例发生率明显低于对照组;SCr浓度、移植肾血流阻力指数亦明显低于对照组;前列地尔组DGF发生率为5.56%,显著低于对照组(10.10%)(P<0.01);两组急性排斥反应发生率差异无统计学意义(分别为10.41%、10.77%;P>0.05)。结论肾移植受者术中及术后早期应用前列地尔可促进移植肾功能的恢复,减少高血压和肝功能异常等常见的并发症。前列地尔对肾移植患者术后早期康复具有促进作用。

Effect of alprostadil on recovery of renal transplant recipients

Objective To assess whether alprostadil has the effect on accelerating recovery of renal transplant recipients.Methods A randomized control clinical trial was designed between January 1,2003 and August 31,2006.Administration of alprostadil was in 298 renal recipients who received 50ug alprostadil while transplanting kidney and each day after the operation.The effects of alprostadil were compared with the control group which included 287 recipients to determine the influences of alprostadil on urine,creatinine(Cr),creatinine clearance(Ccr),blood pressure,alanine aminotransferase(ALT) and aspartate aminotransferase(AST).Under Doppler ultrasound the renal blood flow resistance-indexes(RI) were measured.The rates of acute renal graft rejection(AR)and delayed graft function(DGF) were also calculated in both groups.Results Urine and Ccr were significantly higher in alprostadil-treated group than in control.On the contrary Cr and RI were significantly lower in alprostadil-treated group than in control.alprostadil-treated group also showed a significantly lower incidences of DGF,hypertension and liver dysfunction(ALT or AST was more than 40u/L).But the incidences of rejection in both groups were equal.No side effects were found.Conclusion The application of alprostadil to renal recipients has beneficial effects on accelerating recovery of renal graft function and reducing the incidences of DGF,hypertension and liver dysfunction.