肝移植术后他克莫司加泼尼松免疫抑制治疗的临床疗效

目的 :探讨肝移植术后他克莫司 (FK5 0 6 ) +泼尼松 (Pred)二联免疫抑制治疗方案的临床疗效及药物不良反应。方法 :对肝移植术后应用FK5 0 6 +Pred二联免疫抑制方案治疗的 2 5例患者 (A组 ,术后 2 4h即应用FK5 0 6 +Pred方案的 15例 ,以及因出现排斥反应或严重药物不良反应由CsA +MMF +Pred改为FK5 0 6 +Pred方案的 10例 )和应用环孢素 (CsA) +霉酚酸酯(MMF) +Pred三联免疫抑制方案治疗的 2 0例患者 (B组 )进行比较 ,临床观察 12mo。结果 :2组移植前后血Cr均无明显变化 ,但A组移植术后排斥反应及药物不良反应发生率显著低于B组 (P <0 0 1) ;由CsA +MMF +Pred改为FK5 0 6 +Pred方案的 10例患者 ,排斥反应和药物不良反应均得到有效控制。A组的主要药物不良反应有腹泻和神经系统毒性 ,仅有 2例分别于术后mo 1,2发生血糖升高。结论 :肝移植术后FK5 0 6 +Pred二联免疫抑制治疗方案是有效的

Clinical observation of immunosuppressive program of tacrolimus and prednisone following liver transplantation

AIM:To investigate the clinical effiacy and adverse drug reactions(ADRs) of tacrolimus combined with prednisone in liver transplantation. METHODS:Twenty-five liver transplantation recipients receiving tacrolimus+prednisone program(group A, 15 of them received tacrolimus+prednisone program immediately after transplantation and 10 of them converted from ciclosporin+mycophenolate mofetil+prednisone to tacrolimus+prednisone program because of rejection or ADRs) were compared with 20 receiving ciclosporin+mycophenolate mofetil+prednisone program(B group), the 2 groups were observed for 12 mo. RESULTS:The serum creatinine of 2 groups had no great changes before and after transplantation, but the incidence of rejection and toxicity of group A were lower than that of group B significantly (P<0.01). The rejection or ADRs were controlled in 10 converted from ciclosporin+mycophenolate mofetil+prednisone to tacrolimus+prednisone program. Most of ADRs in group A were diarrhea and toxicity to nervous system, rising of blood glucose level occurred only in 2 cases in the mo l and the mo 2 after operation. CONCLUSION:The immunosuppressive program of tacrolimus and prednisone is effective .