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霉酚酸酯预防肾移植术后近期急性排斥反应的观察 |
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董坚 王祥慧 杨尚琪
摘 要：目的：观察霉酚酸酯(MMF)在预防肾移植术后近期(3个月)急性排斥反应(AR)的情况。方法：将112例患者随机分成2组，MMF(2.0 g/d)组和硫唑嘌呤(Aza)组。两组患者均同时接受相似剂量的环孢素A和类固醇激素治疗。结果：观察3个月，MMF组60例，AR发生率为16.7%(10/60)，Aza组52例，AR发生率为42.3%(22/52)，两组差异有极显著意义(P＜0.01)。MMF组5例出现血白细胞、血小板等不同程度下降，3例出现腹泻，在MMF减量或停药后均恢复正常，未见有MMF引起的肝、肾功能异常病例；Aza组有9例出现肝功能损害。结论：MMF具有预防和减少肾移植术后近期AR效果，MMF的安全性可靠，副作用轻且为可逆性。
关键词：霉酚酸酯 肾移植 移植物排斥 免疫抑制剂
Application of mycophenolate mofetil in prevention of acute renal transplantation
rejection in the near period of postoperation
DONG Jian
(Department of Urology,the Second People′s Hospital of Wuxi,Wuxi,Jiangsu,214002)
WANG Xiang-hui YANG Shang-qi
(Department of Urology,the First People′s Hospital of Shanghai)
Abstract：Purpose：To observe the effect of mycophenolate mofetil (MMF) on prevention of acute renal transplantation rejection in the near period of postoperation. Methods：112 cases of renal transplant recipients were divided into two groups at random .Group MMF (2.0 g/d)and Group Aza. Recipients of the two groups simultaneously received similar doses of CsA and steroids. Results：With in the three months observation, the incidence of acute rejection were 16.7% (10/60) in Group MMF and 42.3% (22/52) in Group Aza respectively (P＜0.01). Of the 60 cases of recipients in Group MMF,5 cases emerged reduction of WBC and platelet,3 cases with diarrhea, which all recovered after rduction or discontinuation of MMF. No case of liver or renal dysfunction were found in Group MMF while 9 cases of recipients of liver dysfunction in Group Aza. Conclusions：MMF can prevent and reduce acute renal transplantation rejection and the side effects of MMF are slight and reversible.
Key words：Mycophenolate mofetil Kidney transplantation Graft rejection Immunosuppressive agents▲
急性排斥反应(AR)是影响移植肾近期和远期存活的主要因素，因其易发生于术后3个月内，故术后近期如何预防和减少AR的发生，始终是肾移植的一个重要课题。霉酚酸酯(MMF)是一种新型免疫抑制剂，它可以选择性抑制T及B淋巴细胞增殖，从而降低AR发生的频率和严重程度〔1，2〕[1] [2] 下一页
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