肾移植后应用霉酚酸酯与硫唑嘌呤的疗效比较

目的:比较肾移植受者应用霉酚酸酯(MMF)与硫唑嘌呤(Aza)的临床疗效.方法:肾移植术后患者86例随机分为MMF组,即用环孢素(CsA)加MMF、泼尼松(Pred)三联用药方案者40例;Aza组为CsA加Aza、Pred三联用药方案者46例;定期监测其肝肾功能、CsA全血浓度等,观察时间为1 a.结果:两组患者术后肾功能恢复情况基本相同,但MMF组患者血肌酐(Cr)值显著低于Aza组,差异有显著性,;MMF组的CsA用量及其血药浓度也显著低于Aza组;MMF对急慢性排斥反应效果较Aza好;两组患者消化道反应、白细胞减少、感染等并发症的发生率差异无显著性,Aza组药物性肝损害发生率高于MMF组.结论:含MMF的三联用药更有利于移植肾功能的恢复和降低肝肾毒性发生率.

A Comparison between the Therapeutic Effects of Mycophenolate Mofetil and Azathioprine in the Management of Patients after Renal Transplantation

Objective:To compare the effects of mycophenolate mofetil(MMF) and azathioprine(Aza) in kidney graft recipients after renal transplantation. Methods:86 kidney graft recipients after renal transplantation were randomly divided into group MMF and group Aza. Patients of the group MMF( n =40) were subjected to the triple drug treatment scheme: cyclosoprine A(CsA)+ MMF+ prednisone(Pred). The drug treatment scheme of the group Aza( n =46) was CsA+ Aza+ Pred. Function of the liver and kidney as well as the whole blood concentration of CsA were monitored at regular intervals for patients of both groups. The period of observation lasted 1 year. Results:The restoration of normal renal function in patients of both groups was basically alike. However, the serum level of creatinine in patients of the group MMF was significantly lower than that of the group Aza. The amount of CsA used and its blood concentration were also remarkably lower in patients of the group MMF than those of the group Aza. MMF had better therapeutic effects on acute and chronic rejections than Aza. Differences were insignificant between the two groups with respect to gastrointestinal reactions, leukopenia, infection ect. The incidence of drug induced liver injury in patients of the group Aza was higher than that of the group MMF. Conclusion:Triple drug medication including MMF was found to be more advantageous to the function restoration of the kidney graft and lowering of the incidence of hepatorenal toxicity.