环孢素A和他克莫司在高危肾移植患者中的应用比较

目的　比较高危肾移植患者术后应用环孢素 A(CsA)和他克莫司(FK506)的疗效和安全性。方法　将58例高危肾移植患者随机分为CsA组(30例)和FK506组(28 例),观察肾移植后 1年内两组的急性排斥发生率和药物逆转率、药物毒副作用及感染发生情况。结果　 FK506组和 CsA组的人/肾存活率分别为100%/100%和93.3%/86.7%;急性排斥反应发生率分别为14.3%和16.7%;抗排斥治疗的逆转率分别为100%和60%。FK506组药物毒副作用也较 CsA组小。结论　在高危肾移植患者的免疫抑制治疗中FK506应为首选。

Comparison of CsA and FK506 used in renal transplantation recipients with high risk factors

Objective To compare the efficiency and safety of CsA and FK506 used in the renal transplantation recipients with high risk factors. Methods Fifty cases with high risk factors of renal transplantation were randomly divided into CsA group ( n =30) and FK506 group ( n =28). The high risk factors included PRA>30%, older or senior recipient, diabetes mellitus, high level blood lipid, re transplantation, DGF, impaired liver function, perioperative infection etc. The follow up period was at least one year. The end points of observation included graft and recipient survival rates, acute rejection, and reversal rate after immunosuppressive drugs bolus, side affects of CsA and FK506 and infection rates in the tow groups. Results The one year patients/grafts survival rate in FK506 and CsA groups was 100% / 100% and 93.3% / 86.7% respectively, the incidence of acute rejection was 14.3% and 16.7% respectively, and reversal rate after immunosuppressive drugs bolus was 100% and 60% respectively. The side effects of FK506 were milder than those of CsA. Conclusion FK506 is the first choice for the renal transplantation recipients with high risk factors.