应用环孢素A的肾移植患者合用地尔硫(艹卓)的临床效果观察

目的探讨使用环孢素A(CsA)的肾移植患者合用地尔硫芯卓的临床效果。方法将1529例肾移植患者分为研究组和对照组,研究组肾移植术后应用CsA、硫唑嘌呤(Aza)及泼尼松(Pred)(研究组1)或CsA、霉酚酸酯(MMF)及Pred(研究组2)预防排斥反应,两个研究组同时加用地尔硫芯卓;对照组使用CsA、Aza及Pred预防排斥反应,不用地尔硫芯卓。观察研究组和对照组的CsA用量、血CsA浓度、移植效果、急性排斥反应发生率以及CsA的肝、肾毒性。结果研究组1的CsA用量低于对照组(P<0.05),但血CsA浓度明显高于对照组(P<0.01);研究组2的CsA用量显著低于对照组(P<0.01),但血CsA浓度与对照组相近(P>0.05);研究组1和研究组2移植肾功能恢复正常的时间分别缩短至4.7d和3.9d,较对照组显著提前(P<0.05);两个研究组的急性排斥反应发生率较对照组明显降低(P<0.05,P<0.01)。结论应用CsA的肾移植患者合用地尔硫芯卓,能明显提高血CsA浓度,从而减少CsA用量,同时能促进移植肾功能的恢复,改善移植效果。

The effects of diltiaze in renal transplantation patients treated with cyclosporine A

Objective To investigate the clinical effects of diltiaze in renal transplantation patients treated with cyclosporine A (CsA). Methods 1529 renal transplant cases were randomly ~divi -ded into experimental group 1 receiving CsA, Aza, Pred and Diltiaze, experimental group 2 receiving CsA, MMF, Pred and diltiaze, and control group receiving CsA, Aza and Pred without diltiaze. The dosage and blood concentrations of CsA, the outcome of renal transplant, the incidence of acute rejection, and the hepatic and renal toxicity were observed in the experimental groups and control group.Results The dosage of CsA in experimental group 1 was less, while the blood concentrations of CsA was higher than in control group (P<~0.05 ,P<~0.01 ), The CsA dosage in experimental group was obviously lower than in control group (P<~0.01 ), but blood concentrations was close to those in control group (P>~0.05 ). The recovery time of the graft function was cut down to 4.7 days (experimental group 1) and 3.9 days (experimental group 2) respectively with the difference being significant between the experimental groups and control group (P<~0.05 ). The accidence of acute rejection in the two experimental groups was significantly lower than in control group (P<~0.05 ,P<~0.01 ). Conclusion The combined use of diltiaze with CsA in renal transplantation patients could obviously increase the blood concentrations of CsA, reduce the dosage of CsA. Simultaneously, it could promote the ~recovery of graft function and improve the effectiveness of transplantation.