西罗莫司在肾移植后近期应用中的疗效分析

目的探讨西罗莫司在肾移植后近期治疗中的应用效果。方法收集使用不同免疫抑制剂方案治疗的50例肾移植患者资料,应用环孢素A(CsA)+西罗莫司(SRL)+泼尼松(Pred)的18例患者为实验组,应用CsA+吗替麦考酚酯(MMF)+Pred的32例患者为对照组。对移植后6个月内的急性排斥反应、移植肾功能及血脂情况进行观察。结果实验组发生排斥反应2例,排斥反应发生率为11.1%;对照组为7例,发生率为21.8%,差异有统计学意义(P<0.05)。术后1个月实验组和对照组肾功能比较差异有统计学意义(P<0.05),术后1周及术后3、6个月2组间比较差异无统计学意义(P>0.05)。术后1、3、6个月实验组患者总胆固醇、甘油三酯及低密度脂蛋白水平均高于对照组,差异有统计学意义(P<0.05),术后1周2组间比较差异无统计学意义(P>0.05)。结论肾移植后近期采用CsA、SRL和Pred联合的免疫抑制治疗方案,可取得较好的免疫抑制效果。显著减少移植肾的急性排斥反应发生率,但高脂血症是SRL临床常见的不良反应。

Application analysis of sirolimus in recent renal transplant recipients

Objective To explore the application effect of sirolimus recent treatment after renal transplantation. Methods Collected from January 2011 to January 2012 in our hospital, the application the different immunosuppressants program 50 cases of renal transplant pa-tients. Cyclosporine A（CsA） ＋ mycophenolate mofetil（ MMF） ＋ prednisone（ Pred） in 32 cases of patients with control group. CsA ＋ sirolimus （SRL） ＋ Pred in 18 cases of patients with experimental group. Observed the occurrence of acute rejection,graft function and blood fat,within 6 months after renal transplantation. Results ①Acute rejection： The experimental group 1 cases of rejection, the rejection rate was 5. 6% ; Control group incidence of rejection in 4 cases,rejection rates for 22. 2% .②Renal function： I month after transplantation experimental group and control group, there are differences in renal function （ P 〈 0. 05 ） ; No difference between the two groups after 1 week, 3 months and 6 months （P 〉0.05）.③Blood fat： Experimental group patients with total cholesterol, triglyceride and low - density lipoprotein levels 1,3,6 months after the surgery were higher than those of control group （P 〈0. 05）,the difference was statistically significant; No difference between the two groups after 1 week （P 〉0.05）. Conclusion Recent renal transplant recipients with SRL, CsA and Pred combined immunosuppres-sive regimen better immunosuppressive effect. Significantly reduce renal allograft acute rejection incidence,but hyperlipidemia is SRL common clinical adverse reactions.