肾移植术后药物性肝损害的诊断与治疗

目的 探讨肾移植术后免疫抑制剂引起肝功能损害的治疗措施。方法 对32例肾移植术后出现肝功能异常的病例进行分析，观察肝功能指标以及CsA浓度，及时调整免疫抑制剂，配合保肝治疗。结果 CsA＋MMF＋Pred发生率22．9％，CsA＋Aza＋Pred发生率31．3％，FKS06＋MMF＋Pred无1例发生肝功能损害。结论 CsA＋MMF＋Pred、FK506＋MMF＋Pred是目前较为理想的免疫抑制治疗方案，低剂量CsA可减少肝毒性的发生。

Diagnosis and treament of hepatic dysfunction after renal transplantation

Objective To investigate the treatment of hepatic injury caused by immunosuppressant. Methods 32 cases with hepatic dysfunction after renal transplantation were analyzed. Hepatic function and cyclosporine concentration were monitored and the dosages of immunosuppressant were adjusted according to the cyclosporine concentration in order to protect liver function. Results The incidence of hepatic dysfunction was 22.9% in patients who took CsA MMF Pred administration, whereas the incidence was 31.3% in patients who took CsA Aza Pred administration. There was no case for hepatic dysfunction in patients who took FK506 MMF Pred administration. Conclusion CsA MMF Pred and FK506 MMF Pred are ideal treatment after renal transplantation, and low CsA concentration can decrease the incidence of hepatic dysfunction.