他克莫司抗同种肾移植排斥反应的临床研究(附136例报道)

目的 研究他克莫司（ＦＫ５０６）在同种肾移植术后抗排斥反应的效果及毒副作用。方法 １３６例肾移植患者在术后２４ｈ开始服用ＦＫ５０６，起始量０．１５ｍｇ．ｋｇ＾－１，ｄ＾－１，同时口服霉酚酸酯（ＭＭＦ）１．０ｇ／ｄ、泼尼松（Ｐｒｅｄ）３０ｍｇ／ｄ。观察ＦＫ５０６的治疗效果、理想的治疗窗及毒副反应。结果 肾移植术后１３６例应用ＦＫ５０６的患者中，肾功能２～７ｄ恢复正常为９６例，８～１５ｄ恢复正常为２３

A clinical research of taerolimus (Prograf) in the prevention of renal allograft rejection:a report of 136 cases

Objective To study the effects and side-effects of tacrolimus(FK506) in the prevention of renal allograft rejection.Methods 136 patients undergoing renal transplantion orally administered FK506 with the initial dose of 0.15 mg/kg daily,mycophenolate mofetil(1.0 g/d)and meticorten (Pred,30 mg/d) 24 h after transplantation.The curative effects,therapy index and side-effects were observed.Results In 136 patients using FK506 after renal transplantation the incidence of acute rejection(AR) was 12.5%(n=17),glycometabolism disorder was 18.4%(n=15),nervous system disturbance was 2.2%(n=3),abnormal liver function was 3.7(n=5),nephrotoxicity was 2.9%(n=4),disordersof digestion Was 22.8%(n=31),cytomegalovirus(CMV) infection was 3.7%(n=5),pulmonary infection was 2.2%(n=3).One died from cerebral hemorrhage but the allograft function was normal and two were removed the allograft because of the function loss.All the blood concentrations of FK506 were 5 to 20μg/L.Conclusions FK506 could decrease the incidence of rejection in kidney transplant recipients with little side effects and toxicity.So it was a safe and effective immunosuppressive agent,particularly in patients who experienced cyclosporine nephrotoxicity.However,glycometabolism disorder caused by FK506 should be paid attention.