肾移植术后普乐可复应用的临床研究

目的研究肾移植术后应用普乐可复免疫抑制治疗的临床疗效和毒副作用。方法随机将62例肾移植受者分成两组：（1）FK506组（n=24）：应用FK506＋骁悉（MMF）＋强的松（Pred）治疗方案;（2）环孢素A（CsA）组（n=38）：应用CsA＋MMF＋Pred治疗方案。结果随访24个月,FK506组有2例（8.3%）、CsA组有9例（23.7%）发生急性排斥反应（P〈0.05）;两组肾功能恢复指标血清肌酐值无明显差异（P〉0.05）;FK506组和CsA组分别有3例（12.5%）和14例（36.8%）发生肝功能损害（P〈0.05）;分别有13例（54.2%）和22例（57.9%）血压升高（P〉0.05）;分别有4例（16.67%）和6例（15.79%）血糖升高（P〉0.05）。结论 FK506具有强效的免疫抑制作用,对于发生急性排斥反应、严重肝功能损害等肾移植术后患者由CsA切换成FK506治疗是安全有效的;应用时须根据血药浓度调整剂量,以减少不良反应的发生。

Clinical Study on the Use of FK506 After Renal Transplantation

Objective To investigate the therapeutic efficacy and side-effects of tacrolimus（FK506） used for renal transplantation.Methods sixty-two cases of renal transplantation recipients were randomly divided into two groups：FK506 group（n=24）,receiving FK506,mycophenolat-mofetil（MMF） and prednisone（Pred） ;CsA group（n=38）,receiving CsA,MMF and Pred.Results Up to date,24 months follow-up showed that acute transplantation renal rejection was found in 2 cases of the FK506 group and 9 cases of the CsA group respectively（P0.05）.The differences in renal function（serum Cr） in the two groups the difference was not significant（P0.05）,hepatic dysfunction occurred in 3 cases in the FK506 group and 14 cases in the CsA group（P0.05）.Hypertension was found in 13 cases the FK506 group and 22 cases in the CsA group（P0.05）.Hyperglycemia occurred in 4 cases in the FK506 group and 16 cases in the CsA group（P0.05）.Conclusion FK506 is a potent immunosuppressive agent,it is effective and safe to substitute CsA by FK506 in renal transplantation recipients with acute transplantation renal rejection and hepatic dysfunction.That the dosage of FK506 should be adjusted according to its wholeblood trough levels is helpful for reducing the side effects.