复方磺胺甲恶唑对肾移植后卡氏肺孢子虫肺炎的预防作用

背景：卡氏肺孢子虫肺炎是由卡氏肺孢子虫寄生于肺部引起的一种严重的致命性肺炎。复方磺胺甲恶唑是目前用于治疗卡氏肺孢子虫肺炎的一线药物,治疗量往往有明显的不良反应,小剂量预防用药临床疗效及毒副作用尚不清楚。目的：观察复方磺胺甲恶唑对肾移植后卡氏肺孢子虫肺炎的预防效果。方法：选择肾移植后1个月且无复方磺胺甲恶唑过敏者。肾移植后1个月至半年或1年常规服用复方磺胺甲恶唑（0.48g/d）。观察移植肝肾功能,感染情况,药物不良反应。结果与结论：2006年起,随访125例肾移植术后早期患者,73例术后1个月起常规服用复方磺胺甲恶唑（0.48g/d）至术后半年者,1例停药4个月后感染卡氏肺孢子虫肺炎死亡,47例服用复方磺胺甲恶唑（0.48g/d）至术后1年者,无感染卡氏肺孢子虫肺炎者,5例因复方磺胺甲恶唑过敏或医从性差未服用复方磺胺甲恶唑者,2例分别在术后4,5个月感染卡氏肺孢子虫肺炎,1例死亡。结果提示,肾移植术后1个月至1年常规服用复方磺胺甲恶唑（0.48g/d）,可有效预防卡氏肺孢子虫肺炎,临床无明显不良反应。

Prevention effect of compound sulfamethoxazole on pneumocystis carinii pneumonia after kidney transplantation

BACKGROUND：Pneumocystis carinii pneumonia （PCP） is a kind of lethal pneumonia caused by pneumocystis carinii （PC） which is parasitize lung. Sulfamethoxazole is a first-line drug for PCP treatment,while there is obvious side effect when using therapeutic dose. The efficacy and side effect of small dose of SMZ is unclear. OBJECTIVE：To observe the effect of small dose of compound sulfamethoxazole （SMZco） for prevention of PCP after kidney transplantation. METHODS：Patients who were taken kidney transplantation for just one month and not sensitive to SMZco were selected. All the participants took SMZco （0.48 g/d） for half a year to one year. The graft and liver function,infection situation and side effects were surveyed. RESULTS AND CONCLUSION：We finally enrolled 125 patients in which 73 participants took SMZco for half a year and other 47 for 1 year. As a result,one patient who took SMZvo for half a year was died of PCP at 4 months after drug withdraw. While no one died in the 1 year treatment group. In addition,there were 5 patients had not taken SMZco for hypersusceptibility or bad compliance in which 2 cases caught PCP after 4 and 5 months respectively and 1 cases died. Using small dose of SMZco at 1 month after kidney transplantation for 1 year is effective for prevention of PCP and has no side effect.