丹参及冬虫夏草制剂在肾移植中应用的临床研究

目的总结112例肾移植手术的临床经验,观察丹参及冬虫夏草制剂在肾移植中的临床效果。方法回顾性分析了2003—2007年的112例同种异体肾移植患者的临床资料。将术后患者(脱落10例)随机分为治疗组56例、对照组46例,2组均常规服用免疫抑制剂,治疗组加用丹参及虫草制剂。观察人、肾1,3,5年存活率,术后排斥反应及并发症情况,患者死亡的主要原因,2组人、肾5年存活率及出现肾功能异常情况,并发慢性移植肾肾病(CAN)后的治疗情况。结果 112例中人、肾1,3,5年存活率(人、肾均存活)分别为96.4%,85.7%,74.1%。术后1例发生加速排斥反应,9例发生急性排斥反应,8例发生急性肾小管坏死,围手术期死亡人3例,1例出现外科并发症尿瘘。112例中术后失访6例,共死亡11例,除围手术期死亡3例外,其余8例均为带正常肾功能死亡。其中5例因恶性肿瘤死亡,占4.5%。人、肾5年存活率比较:治疗组56例中46例存活,存活率为82.1%,对照组46例中37例存活,存活率为80.4%,2组比较差异无统计学意义(P>0.05)。5年中治疗组56例中发生肾功能异常者9例,发生率为16.1%,对照组46例中发生肾功能异常者19例,发生率为41.3%,治疗组肾功能异常的发生率低于对照组(P<0.01)。2组患者术后因肾功能异常诊断为CAN者共28例。在免疫抑制剂减量或切换免疫抑制剂的同时采用丹参粉针静点治疗,连续2周静脉滴注,治疗前后血肌酐平均下降(84.3±24.5)μmol/L。结论在常规抗排异治疗的基础上加用丹参及冬虫夏草制剂对肾移植患

Clinical study on preparations of Danshen (Radix Salviae Miltiorrhizae) and Dongchongxiacao (Cordyceps) applied in renal transplantation

Objective Salviae Miltiorrhizae） and Dongchongxiacao（Cordyceps） applied in renal transplantation in 112 patients.Methods The clinical data of 112 patients with renal transplantation were retrospectively analyzed from 2003 to 2007.The patients were randomly divided into treatment group（n=56） and control group（n=46）.The two groups were treated with immunosuppressant and treatment group was additionally given preparations of Danshen and Dongchongxiacao.The survival rates of both patients and kidneys after 1 year,3 years and 5 years,postoperative rejection,complications,major causes of death,and abnormal renal function were observed respectively.The treatment of chronic allograft nephropathy（CAN） was observed too.Results The survival rates of both patients and kidneys were 96.4%,85.7% and 74.1% in 112 patients,respectively,after 1 year,3 years and 5 years.There was 1 and 11 missed follow-up.There were totally 11 cases died,among them 3 died in perioperative period and 8 died with normal renal function including 5 died of cancer（4.5%）.The comparison of survival rates of both patients and kidneys after 5 years showed that the survival rate was 82.1%（46/56） in treatment group and 80.4%（37/46） in control group（P0.05）,and incidence of abnormal renal function was 16.1%（9/56） in treatment group and 41.3%（19/46） in control group（P0.01）.There were 28 cases diagnosed as CAN in two groups.At the same time of reducing the dose of immunosuppressant or changing it,these cases were given intravenous drip of Danshenfen Injection for 2 weeks and the level of serum creatinine decreased averagely by（84.3±24.5） μmol/L.Conclusion The additional application of the preparations of Danshen and Dongchongxiacao besides of routine anti-rejection treatment has a good curative effect in the patients with renal transplantation,and similarly preparation of Danshen has the therapeutic effect on CAN.