肝移植患者使用基于他克莫司或环孢素的免疫抑制方案后3年内肾功能的变化比较

目的:在这项回顾性研究中,分析了肝移植术后患者连续使用钙调磷酸酶抑制剂(环孢素vs他克莫司)前3年内的肾功能变化。方法:回顾性分析某院肝脏移植中心214名肝移植(LT)患者的资料。所有患者在LT后的前3年内均接受以钙调磷酸酶抑制剂(CNI)为基础的免疫抑制治疗,收集患者随访期间(6,12,18,24,36个月)各项指标包括血常规、肝肾功能、血糖、免疫抑制剂药物剂量及浓度等,比较患者随访期间肾功能的变化情况。结果:2组患者在接受CNI为基础的免疫抑制方案治疗后的前3年内肾功能均有不同程度的下降,环孢素组患者在移植后半年内即出现肾功能的恶化(P<0.05),而他克莫司组患者肾功能1年后也出现了显著恶化(P<0.05)。结论:与接受基于TAC的免疫抑制方案治疗的患者相比,CSA组出现肾功能恶化更明显,尤其是在LT后的前6个月。

Comparison of renal function in liver transplant patientstreated with tacrolimus-based or cyclosporin-based immunosuppressive regimens within 3 years

OBJECTIVE In this retrospective study, changes in renal function during the first 3 years of continuous use of a calcineurin inhibitor (cyclosporine (CSA) vs. Tacrolimus (TAC)) after liver transplantation were analyzed.METHODS Data of 214 LT patients in the liver transplantation center of our hospital were retrospectively analyzed. All patients were treated with CNI-based immunosuppressive agents within the first 3 years after LT. During the follow-up period (6, 12, 18, 24, 36 months), indicators including blood routine, liver and kidney function, blood glucose, immunosuppressive drug concentration were collected to compare the changes of renal function during the follow-up period.RESULTS Renal function decreased to some extent in the first 3 years after CNI-based immunosuppressive regimen in both groups. Patients in cyclosporine group had deterioration of renal function within 6 months after transplantation (P<0.05), while patients in tacrolimus group also had significant deterioration of renal function after 1 year (P<0.05).CONCLUSION Renal function deterioration was more pronounced in the CSA group compared with patients treated with TAC-based immunosuppressive regimens, especially in the first 6 months after LT.