霉酚酸酯治疗慢性移植物功能减退的多中心研究

目的　探讨霉酚酸酯 (MMF)治疗慢性移植物功能减退 (CAD)的疗效和安全性。方法　应用霉酚酸酯 (MMF)替换硫唑嘌呤 (Aza)或环磷酰胺 (CTX) ,并联合小剂量环孢素A(CsA)和泼尼松 (Pred )治疗 78例CAD患者的方案。平均随访 9.84个月 ,研究并分析该方案的效果和并发症。结果　应用MMF联合小剂量CsA和Pred治疗后 ,有 74例患者的血清肌酐 (SCr)下降 ,随访时与应用前比较 ,差异有显著性 (P <0 .0 5 ) ;治疗有效率达 94 .9% ;4例治疗无效。用MMF转换治疗后 ,尿蛋白减轻或消失 ,血压下降。贫血、腹泻等不良反应发生率为 33.3%。结论　MMF联合小剂量CsA和Pred治疗CAD是有效和安全的。贫血、腹泻是转换治疗的主要副作用。

Treatment of chronic allograft dysfunction with mycophenolate mofetil after kidney transplantation:a multicenter study

Objective To investigate the therapeutic effectiveness and safety of mycophenolate mofetil (MMF) in the treatment of chronic allograft dysfunction (CAD).Methods Seventy-eight patients with CAD were administrated with MMF substituting for Aza or CTX with concomitant low-dose CsA. The effectiveness and complications were analyzed. The mean follow-up time after MMF treatment was 9.48 months.Results After treatment with MMF in combination with low doses of CsA and Pred,the serum creatinine concentration (SCr) in 74 CAD patients was significantly decreased and remained stable at the end of follow-up ( P < 0.05 ). Four out of 78 CAD patients finally failed. The total effective rate was 94.9 % . Blood pressure was lowed and proteinuria attenuated or abolished after MMF treatment. The rate of adverse effects was 33.3 % .Conclusions MMF combined with low-dose CsA and Pred is an effective and safe regime for the treatment of CAD. Side effects of MMF regime as diarrhea and anaemia were observed.