含西罗莫司的四联免疫抑制剂方案对肾移植术后患者肾功能、T淋巴细胞亚群及预后的影响

目的:探究含西罗莫司的四联免疫抑制剂方案对肾移植术后患者肾功能、T淋巴细胞亚群及预后的影响。方法:选取2017年1月至2021年1月在郑州市第七人民医院接受肾移植手术患者115例为研究对象，根据药物治疗方案分为A组（66例）和B组（49例）。A组男29例、女37例，年龄（47.6±14.3）岁，采用三联免疫抑制治疗；B...

Effects of sirolimus-containing quadruple immunosuppressor on renal function,T lymphocyte subsets,and prognosis in patients after renal transplantation

Objective　To explore the effects of sirolimus-containing quadrupleimmunosuppressor on renal function, T lymphocyte subsets, and prognosis inpatients after renal transplantation. Methods　A total of 115 patients undergoing renal transplantation in ZhengzhouSeventh People's Hospital were enrolled as the research objects between January2017 and January 2021. According to different treatment regimens, they weredivided into group A [29 males and 37 females, aged (47.6±14.3) years] andgroup B [23 males and 26 females, aged (45.2±14.7) years]. Group A was treatedwith triple immunosuppressor, and group B was treated with sirolimus-containingquadruple immunosuppressor on the basis of group A. The renal function indexes[serum creatinine (Scr), β2-microglobulin (β2-MG), and cystatin C (CysC)] and Tlymphocyte subsets before and 6 months after surgery, and occurrence ofpostoperative acute rejection, transplanted kidney loss, lung infection, and deathwere compared between the two groups. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　Before treatment, there were no statistically significant differences inthe levels of Scr, β2-MG, and CysC between the two groups (all P>0.05); after treatment, the levelsof Scr, β2-MG, and CysC in group B were (104.39±30.91) μmol/L, (2.94±1.71)mg/L, and (0.79±0.15) mg/L, respectively, which were lower than those in groupA [(128.54±37.21) μmol/L, (3.57±1.29) mg/L, and (0.86±0.12) mg/L], withstatistically significant differences (all P<0.05).Before treatment, there were no statistically significant differences in thelevels of CD3⁺, CD8⁺, and CD4⁺/CD8⁺ between the two groups (all P>0.05);there was no statistically significant difference in the CD4⁺ levelbetween the two groups before and after treatment (both P>0.05); after treatment, the levels of CD3⁺, CD8⁺,and CD4⁺/CD8⁺ in group B were (60.90±10.15)%,(20.06±6.69)%, and (1.21±0.14), respectively, which were lower than those ingroup A [(65.29±10.58)%, (22.65±6.94)%, and (1.27±0.17)], with statisticallysignificant differences (all P<0.05).There was no statistically significant difference in the incidence of adversereactions within 6 months after renal transplantation between the two groups (P>0.05). Conclusion　The application of sirolimus-containing quadruple immunosuppressor afterrenal transplantation can better regulate immune function, without aggravatingrenal function injury.