前列地尔在肾移植术后早期应用的临床研究

目的:观察前列地尔在肾移植术后早期的应用对促进移植肾功能恢复的效果。方法:比较93例肾移植受者术后2周内给予前列地尔20μg.d-1(治疗组),同期85例术后未使用前列地尔的肾移植受者(对照组),比较2组术后尿量、血肌酐、彩色多谱勒监测移植肾血流阻力指数、肾功能延迟恢复和急性排斥反应的发生率以及1a人/肾存活率。结果:治疗组术后1d的24h尿量(9.40±1.9)L明显高于对照组(8.11±1.8)L(P<0.01),而术后1d血肌酐、术后5d血流阻力指数、肾功能延迟恢复的发生率((553.4±51.8)μmol·L-1、0.642±0.035、7.53%)则明显低于对照组((624.6±65.2)μmol·L-1、0.689±0.037、14.12%)(P<0.01);2组之间急性排斥反应发生率(9.68%,10.59%)和1a人/肾存活率(98.9%/95.7%,98.8%/95.3%)无明显差异。结论:肾移植受者术后早期应用前列地尔有利于术后移植肾功能的恢复,但对术后急性排斥反应率和1a人/肾存活率的影响不明显。

Clinical Efficacy of Prostaglandin E1 Used Early for Patients after Renal Transplantation

OBJECTIVE： To observe the clinical efficacy of prostaglandin E1 used early in patients after renal transplantation. METHODS： 93 renal transplant recipients （treatment group） were treated with PGE1（20μg · d ^-1） within 2 weeks after operation, and another 85 renal transplant recipients （control group） were not given PGE1 therapy in the same period. Urine volume, serum creatinine （Scr）, blood flow resistance-indexes （RI） under Doppler color ultrasound, incidences of acute rejection （AR） and delayed graft function （DGF） and the 1 year patient/graft survival rates were compared between the two groups. RESULTS： The 24h urine volume in the treatment group on day 1 after operation was significantly higher than in the control group （9.40 ± 1.9 L vs. 8.11± 1.8L） （P〈 0.01）; however, the Scr on day 1, R I on day 5, and the incidence of DGF were significantly lower in the treatment group （ 553.4 ± 51.8）μmol · L ^-1, 0.642 ± 0.035, and 7.53%, respectively） than in the control group （624.6± 65.2）μmol · L ^-1, 0.689± 0.037, and 14.12%, respectively） （P〈0.01） . No significant differences were found between the two groups in AR rate （9.68% vs. 10.59 % ） and the 1 - year patient/graft survival rates （98.9% and 95.7% vs. 98.8% and 95.3% ） . CONCLUSION： The early use of PGE1 for renal recipients after undergoing renal transplantation can contribute to the early recovery of renal function, but it has little impact on acute renal rejection rate and thelyear patient/graft survival rates.