免疫抑制剂FK506加速周围神经损伤修复后功能恢复的初步临床报告

目的探讨免疫抑制剂FK506加速临床周围神经损伤修复后功能恢复的可能性.方法严格选择15例肢体神经断裂修复术后1d～3个月志愿者,男性12例,女性3例,年龄18～45岁.口服FK506胶囊,1mg～8mg/d,定期监测血药浓度并以此调节剂量,实际用药时间2～6月.定期评价神经再生及功能恢复.结果15例患者均有效,Tinel征、肌电图、临床神经功能恢复评价等综合显示神经再生速度达2.2～4.0 mm/d,平均3.1mm/d,快于同期肢体神经断裂修复术后非免疫抑制对照组1.2mm/d的速度.FK506血药浓度维持在3～5ng/ml,所有患者未出现明显的药物副作用.结论免疫抑制剂FK506可用于周围神经损伤修复后的临床治疗,促进神经快速再生,加速肢体功能恢复,值得进一步探讨.

Preliminary report on clinical application of immunosuppresssant FK506 for accelerating functional restoration after peripheral nerve repair

Objective To explore the possibility of clinical application of immunosuppresssant FK506 (tacrolimus) for accelerating functional restoration after peripheral nerve repair. Methods 15 cases of clinical adult volunteers were selected to accept FK506 therapy, and regular examination were done for functional evaluation. All patients were preformed suture operations of injuired nerve before receiving FK506 therapy. The dosages of FK506 were 1mg/d-8mg/d by oral administration for 2 month to 6 months. Results The Tinel's sign, EMG, and clinical functional restoration showed that all nerves of 15 cases regenerate at 2. 2 mm/d-4.0mm/d, average 3.1mm/d. The clinical results do show that autogenous nerve regeneration under immunosuppresion is much faster than the rate expected in non-immunosuppresion. The blood concentration of FK506 was maintained to less than 8ng/ml, in general at 3ng/ml-5ng/ml. All patients had not any obvious side effect of FK506. Conclusions Immunosuppresssant FK506 could promote nerve regeneration and accelerate functional restoration after peripheral nerve repair. It is necessary to study the characteristic and mechanism of nerve rapir regeneration under immunosuppressive state before extensive application of immunosuppresssant FK506 for promoting autogenous nerve regeneration .