他克莫司替代环孢霉素A后对肾移植术后患者血脂的影响(1)
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[摘要] 目的：探讨用他克莫司(FK506)替换环孢霉素A(CsA)后对肾移植术后患者血脂和移植肾功能的影响。方法：选择本院接受同种异体肾移植术后的 41例患者作为研究对象，其中，男21例，女20例，平均(38.2±22.5)岁。针对临床上应用CsA的患者中出现的一些毒副作用，将这些患者用FK506替换治疗随访 1年以上，监测血清肌酐 (SCr)、尿素氮、血脂等生化指标的变化情况。结果：绝大多数受者血脂浓度显著降低，其中12例患者血脂水平已明显正常；肌酐和尿素氮清除率明显改善(P<0.05)。结论：在某些情况下，用FK506替换CsA可以使心脑血管和肾功能得到改善，并使毒副作用减轻或消失，有助于提高肾移植的长期存活率。
[关键词] 环孢霉素；他克莫司；肾移植；高血脂
[中图分类号] R699.2 [文献标识码]A[文章编号]1674-4721(2011)02(c)-016-03
Effects of tacrolimus instead of CsA which was used in patients after kidney transplantation on serum lipids
GUO Kai, LIU Xuhua, ZHU Minghui
(The People′s Hospital of Zhengzhou City, Henan Province, Zhengzhou 450003, China)
[Abstract] Objective: Study on effects of tacrolimus instead of CsA which was used in patients after kidney transplantation on serum lipids and renal function. Methods: A total of 41 patients received renal transplantation as research subjects in our hospital including 21 males and 20 females and the mean age was (38.2±22.5) years. Because of the clinical application of CsA in patients with the emergence of some side effects, these patients were treated by FK506 instead of CsA and more than 1 year follow-up and monitored of serum creatinine, SCr, blood urea nitrogen, blood lipids and other biochemical changes. Results: Most subjects affected by significantly lower blood lipid levels, including 12 patients had apparently normal lipid levels and creatinine and urea nitrogen clearance of most patients were significantly improved (P<0.05). Conclusion: In some cases, replacing CsA with FK506 can make cardiovascular and renal function improved, reduce side effects, and help to improve the long-term kidney transplant survival.
[Key words] CsA; Tacrolimus; Renal transplantation; Hyperlipidemia
在应用环孢霉素 A(CsA)时代，肾移植术后的存活率已显著提高，但是影响移植肾长期存活率肾移植患者术后的生活质量愈来愈受到移植界的关注，服用免疫抑制剂CsA后患者出现了诸如肾毒性、高血压、高血脂等一系列不良反应。本研究旨在观察将 CsA 换成以他克莫司(FK506)为基础的免疫抑制方案对患者肾功能、血脂、血压等指标的影响，探讨 FK506替代CsA治疗后的临床效果。
1 资料与方法
1.1 一般资料
以 2008年5月～ 2009年10月在郑州人民医院接受同种异体肾移植术后的 41例患者作为研究对象，其中，男 21 例，女20例，平均(38.2±22 ......
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