肾移植术后两种免疫抑制方案的对比研究

目的 探讨两种免疫抑制方案的疗效和副作用。方法 根据肾移植术后所用免疫抑制方案将121例肾移植分为两组，CMP方案组：环孢霉素A(CsA) 霉酚酸酯(MMH) 泼尼松(Pred)，CAP方案组：CsA 硫唑嘌呤(Aza) Pred，术后观察两组移植。肾功能，排斥反应发生频率及免疫抑制剂的用量和副作用。结果 术后CMP组急性排斥反应发生率低于CAP组，而排斥反应的逆转率却高于CAP组；术后半年内CMP组CsA用量低于CAP组CAP组肝肾中毒，骨髓抑制的发生率明显低于CAP组，两组感染的发生率无明显差异。结论 肾移植术后CMP方案优于CAP方案；MMF在肾移植术后的应用，可以减少肾移植排斥反应的发生，减少药物的副作用，提高肾移植的成功率。

Comparative study of two immunosuppressive regimens following kidney transplantation

Objective To compare the therapeutic effects and side effects of two immunosuppressive regimens following kidney transplantation. Methods According to different drug combinations, 121 allograft recipients were divided into two groups: group CMP (82) receiving cyclosporin A (CsA) + mycophenolate mofetil(MMF) + pred-nisone (Pred) and group CAP (39) receiving CsA + Azathioprine (Aza) + Pred. The recovery of renal function, rejection episodes and the doses and side effects of immunosuppressive drugs after operation in the two groups were observed. Results The rejection rate was lower in group CMP than that in group CAP. The doses of CsA used in group CMP were lower than those in group CAP in the first half year after operation. The incidence of liver toxicity, renal toxicity and inhibition of bone marrow was significantly lower in group CMP than that in group CAP. There was no difference in infection rate in the two groups. Conclusion CMP immunosuppressive regimen is superior than CAP. The use of MMF can decrease the incidence of rejection and side effects of the immunosuppressive drugs as well as improve the success rate of transplantation.