血清肝炎病毒标志物阳性肾移植患者临床用药特点

目的 探讨血清肝炎病毒标志物阳性。肾移植患者术后临床用药特点。方法 40例同种异体。肾移植患者，男22例，女18例。年龄30～56岁。其中乙型肝炎感染29例、丙型肝炎感染9例、乙型肝炎合并丙型肝炎感染2例。患者肝功能正常，随机分为普乐可复组（n=20），环孢素A组（n=20）。观察患者术后肝、肾功能情况及人／。肾存活率。结果 40例患者术后随访2年，普乐可复组肝功能异常发生率、急性排斥反应发生率明显低于环孢素A组（分别为15％vs30％，5％vs20％），2组2年人／肾存活率均为100％。结论 血清肝炎病毒标志物阳性患者接受肾移植术后首选普乐可复作为基础免疫制剂方案，可减少排斥反应发生率，对肝脏的损害程度轻。

Clinical characteristics of drug therapy in renal transplant recipients with hepatitis B and C virus infection

Objective To investigate the clinical characteristics of immunosuppressive therapy in renal transplant recipients with positive markers of serum hepatitis.Methods Forty renal transplant recipients(22 men and 18 women;age range,30-56 years) were included.Of them,29 cases had hepatitis B virus infection,9 cases hepatitis C virus infection,and 2 cases hepatitis B and C virus infection.Their liver functions were all normal.They were randomly divided into 2 groups:tacrolimus(Fk506)group(n=20) and cyclosporine(CsA) group(n=20).The liver and renal function and 2-year survival rate of these patients and grafts were analyzed.Results Follow-up lasted 2 years in the 40 patients.The rates of liver dysfunction and acute rejection in Fk506 group were significantly lower than those in CsA group(15% vs 30%,5% vs 20%,respectively;P<0.05).The 2-year person/graft survival rates were both 100% in the 2 groups.Conclusions Fk506 can be chosen as primary immunosuppressive drug in renal recipients with hepatitis B and C virus infection.Fk506 can reduce acute rejection rate and cause less damage to the liver.