免疫抑制剂在心脏移植中的应用现状

硫唑嘌呤＋环孢素A＋泼尼松是原位心脏移植术后免疫抑制治疗的经典方案。随着新抗增殖因子及新的免疫诱导因子的出现，新的治疗方法也为治疗提供了新的选择。目前在免疫抑制治疗中被广泛关注的问题包括：急性排斥反应、心脏移植物血管病变的预防以及血管排斥的治疗。如何保护肾功能、延缓心脏移植物血管病变的发展、降低机会性感染等并发症的发生仍然是免疫抑制治疗所面临的挑战。

Current status of immunodepressants in heart transplantation

Since the technique of orthotopic heart transplantation was succeeded in 1967, the field of immunosuppressive therapy has been rapidly developing. By the late 1980s, triple therapy using azathoprine, cyclosporine and prednisone became a standard regimen. However, this regimen has been replacing by newer antiproliferative agents and newer immunoinduction agents. Extensive concerns in immunosuppressive therapy are focusing on the prophylaxis of acute rejection and of cardiac allograft vasculopathy, and the therapy of vascular rejection. Challenges immunosuppressive therapy is facing include the prophylaxis of renal sparing and cardiac allograft vasculopathy and reduction of the risk of opportunistic infections.