肾移植术后长期应用他克莫司的临床观察

目的　探讨肾移植术后长期应用他克莫司 (FK5 0 6 )的临床疗效和安全性。方法　对肾移植术后符合入选条件的 12 6例服用FK5 0 6和 10 9例服用环孢素A(CsA)的患者进行为期 3年的随访。详细记录了患者的服药剂量、FK5 0 6和CsA谷值浓度 ,观察排斥反应、毒副反应发生率 ,计算人 /肾存活率。结果　FK5 0 6组和CsA组 1、3年人 /肾存活率分别为 :98.4 % / 96 .8%、95 .2 % / 90 .5 %和 97.2 % / 96 .3%、94 .4 % / 89.0 % ;急性排斥反应发生率分别为 :13.5 %和 19.3% (P <0 .0 5 ) ;慢性排斥反应发生率分别为 :3.2 %和 8.3% (P <0 .0 5 ) ;糖代谢紊乱发生率分别为 :16 .7%和 9.2 % (P<0 .0 5 ) ;神经精神毒性分别为 :14 .3%和 12 .0 % ;肝功能损害分别为 :6 .3%和 10 .1% (P <0 .0 5 ) ;肾功能损害分别为 :3.2 %和 8.3% (P <0 .0 5 ) ;脱发分别为 :5 .6 %和 0 (P <0 .0 5 ) ;感染分别为 :7.1%和 6 .4 %。结论　FK5 0 6长期使用疗效确切 ,毒副反应发生率较低。

Long-term evaluation of FK506 based immunosuppressive therapy in kidney transplantation

Objective To explore the long-term clinical effect and safety of tacrolimus (FK506) in renal transplant recipients. Methods There were 126 recipients received FK506 based immunosuppressive therapy and 109 recipients received Cyclosporine A (CsA) based immunosuppressive therapy enrolled into our study according to the criterion and were followed up for 3 years. The dose and trough blood concentrations of FK506, incidence of rejection and side-effect, survival of patients and grafts were recorded in detail. Results The 1-, 3-year patients/grafts survival of FK06 group and CsA group were 98.4?% / 96.8?% , 95.2?% / 90.5?% and 97.2?% / 96.3?% , 94.4?% / 89.0?% , respectively. The incidence of acute rejection was 13.5?% and 19.3?% ( P < 0.05 ), of chronic rejection was 3.2?% and 8.3?% ( P < 0.05 ), of glycometabolism disorder was 16.7?% and 9.2?% ( P < 0.05 ), of nervous system disturbance was 14.3?% and 12.0?% , of abnormal liver function was 6.3?% and 10.1?% ( P < 0.05 ), of nephrotoxicity was 3.2?% and 8.3?% ( P < 0.05 ), of alopecia was 5.6?% and 0 ( P < 0.05 ), and of infection was 7.1?% and 6.4?% in FK506 group and CsA group, respectively.Conclusion Long-term application of FK506 was very effective and incidence of its side effect was low.