肝移植术后应用无激素免疫抑制方案的探讨

目的 探讨肝移植术后联合应用他克莫司(FK506)、霉酚酸酯(MMF)和达利珠单抗的无激素免疫抑制方案的效果.方法 根据双盲和随机原则,将60例因良性终末期肝病而进行肝移植的受者分为研究组与对照组,每组各30例.研究组采用的免疫抑制方案为:FK506+MMF+达利珠单抗;对照组为:FK506+MMF+激素.术后对受者进行长期随访,比较两组存活率及并发症等方面的差异.结果 研究组受者术后1、2年存活率分别为89.3%和90.2%,对照组为70.2%和73.3%;研究组移植物1、2年存活率分别为92.4%和91.1%,对照组为75.1%和73.2%;研究组和对照组术后3个月内急性排斥反应发生率分别为20.0%和28.5%;两组的差异均无统计学意义(P＞0.05).研究组受者伤口愈合不良、感染、高血压病、糖尿病、高胆固醇血症以及乙型肝炎复发的发生率明显低于对照组(P＜0.05).结论 肝移植术后联合应用FK506、MMF和达利珠单抗的无激素免疫抑制方案效果良好,并发症的发生率较少.

Using tacrolimus,mycophenolate and senipen for no-hormone immunosuppressive therapy after liver transplantation

Objective To investigate the effect of using tacrolimus,mycophenolate and senipen for no-hormone immunosuppressive therapy after liver transplantation. Methods Patients with final stage liver diseases were divided into two groups by double-blind and random principle. The study group(n=30) underwent immunosuppressive therapy for the patients after liver transplantation by using tacrolimus,mycophenolate and senipen,and the control group(n=30) by using tacrolimus,mycophenolate and hormone. Results There was no significant diference between two groups in 1- or 2-year survival rate,graft survival rate,acute rejection incidence 3 months after operation. The incidence of intention badness and infection,hypertensive disease,diabetes,hypercholesterinemia and type B hepatitis recurrence in the study group was lower significantly than in control group.Conclusion Using tacrolimus, mycophenolate and senipen for no-hormone immunosuppressive therapy after liver transplantation has good effect with lower incidence of complications.