摘要
目的探讨咪唑立宾(MZR)与环孢素A(CsA)和激素组成基础免疫抑制方案在同种肾移植中的有效性与安全性。方法28例首次肾移植患者(男19例,女9例)随机分为2组:MZR组,14例,MZR初始剂量为1、2mg/(kg·d);MMF组,14例,MMF初始剂量采用1.5～2.0g/d。两组均接受CsA与激素联合的基础免疫抑制方案,CsA浓度保持同一水平,随访6个月。结果两组人、肾存活率均为100%,各出现1例次急性排斥反应,术后24周肌酐平均水平,MZR组为(100.2±1.7)μmol/L,MMF组(98.6±2.5)μmol/L,没有显著性差异(P>0.05)。副作用方面,胃肠道不适和白细胞减少等两组类似,而MZR组出现2例高血糖,可能与激素有关。结论MZR用于肾移植术后维持免疫抑制治疗,可成功替代MMF,有效预防急性排斥发生。
[Objective] To investigate the efficacy and safety of Mizorlbine （MZR, bredinin） versus Mycophenolate mofetil （MMF） as maintainance agent in Cyclosporine （CsA）-based immunosuppressive regime in kidney transplantation. [Methods] Twenty-elght cadaveric kidney allograft recipients （male/female 19/9） were involved. The donor kidneys were harvested en bloc and flushed through WMO-1 solution. Warm ischemic time was 3-7 minutes, and cold ischemic time was 5-16 hours. These patients were divided into 2 groups： （1） CsA ＋MZR （n=14）： the patients received MZR at a initial dose of 1-2 mg/（kg.d） in combination with CsA and Corcosteriod. CsA＋MMF （n=14）： patients received the triple-combined regime with CsA. MMF （1.5-2 g/d） and Corcosteriod as primal, immunosuppressants. [Results] There was no loss of grafts or patients in each group at 6 months follow-up. No significant difference （P 〉0.05）with respect to the episodes of acute rejection （1/14 in MMF group vs. 1/14 in MZR group） and mean serum creatinine level [（98.6±2.5） μmol/L in MMF group vs. （100.2±1.7） μmol/L in MZR group] were observed. The incidence of gastrointestinal dysfunction and leukopenia were comparable. Nevertheless, 2 cases in MZR group underwent transient hyperglycemia probably due to high-dose Corcosteriod. [Conclusion] MZR is a potent immunosuppressant with lower hepatic toxicity. Instead of MMF, MZR could be used effectively as maintainable agent in Cyclosporine-based regime in kidney transplantation.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第17期2629-2631,共3页
China Journal of Modern Medicine
关键词
咪唑立宾
免疫抑制
移植
Mizoribine
immunosuppression
kidney transplantation
