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1、腎移植患者應(yīng)用咪坐立賓臨床探究作者：李曉北，尹航，胡小朋，王瑋，張勇，馬麟麟，王勇，張小東【摘要】目的：研究咪呢立賓(MZR)在腎移植患者中應(yīng)用的臨床特點(diǎn)。方法：2005年9月至2006年2月間共16例腎移植患者接受MZR治療。5例患者為腎移植術(shù)后直接應(yīng)用MZR,11例患者由于經(jīng)濟(jì)原因從霉酚酸酯(MMF)切換成MZR。全部患者均采用以鈣調(diào)神經(jīng)蛋白抑制劑為基礎(chǔ)的三聯(lián)免疫抑制方案。本組患者隨訪期間重點(diǎn)監(jiān)測(cè)用藥后血常規(guī)、移植腎功能、肝功能、尿酸、血糖、血脂等生化指標(biāo)，同時(shí)記錄患者出現(xiàn)的所有臨床不良反應(yīng)及治療
2、，包括：各種細(xì)菌、病毒感染，移植腎急性排斥反應(yīng)等。綜合評(píng)價(jià)該藥物作為免疫抑制治療方案的安全性、有效性。結(jié)果：在MZR治療后3個(gè)月~15個(gè)月的隨訪期間，患者全部存活，且移植腎功能良好。急性排斥發(fā)生率為12.5%,未出現(xiàn)難治性排斥。消化道副反應(yīng)發(fā)生少?；颊咧饕涣挤磻?yīng)是高尿酸血癥和骨髓抑制，但通過(guò)MZR減量及對(duì)癥處理后基本都可以控制，預(yù)后好。術(shù)后感染方面與其他藥物相比差異無(wú)顯著性。結(jié)論：MZR是一種安全有效的免疫抑制劑，具有療效穩(wěn)定，副反應(yīng)程度輕的特點(diǎn)。在嚴(yán)密隨訪的情況下可取得良好的臨床效果?！娟P(guān)鍵詞】咪
3、哇立賓；免疫抑制劑；腎移植ClinicalStudyofMizoribineinRenalTransplantRecipientsTheAffiliatedBeijingChaoyangHospitalofCapitalUniversityofMedicalSciences,Beijing100043,ChinaAbstract：ObjectiveTostudytheclinicalefficacyandcharacteristicsofMizoribine(MZR)inrenaltransplant
4、recipients.MethodsSixteenpatientswhowereadministeredwithMZRfromSeptember2005toFeburary2006wereenrolledinthisstudy.Alltherecipientswerethefirsttransplantsandtookthetripleimmunosuppressiveprotocolwhichbasedoncalcineurininhibitoragents.MZRwastakendirectlyj
5、ustafterrenaltransplantationin5patients,whiletheconversionfromMMFtoMZRwasdoneinother11patientsduetoeconomicreasons?Thebiochemicalitemsandclinicalsymptomsweremonitoredandrecorded.Theclinicaldataoftheserecipientswasanalyzedretrospectively.ResultsDuringthe
6、followupperiod,all16patientswerealiveingoodconditions.Theyhadstableandalmostnormalrenalgraftsfunction,including2patientsrecoveredfromacuterejectionepisodeafterantirejectiontherapies?Theadverseeventsingastrointestinaltractwererare?Themainadversereactions
7、werehyperuricemiaandmyelosuppression.However,loweringthedosageofMZRaswellassymptomatictreatmentscouldamelioratesuchkindsofadverseevents?Theincidenceofinvolvedposttransplantinfectionwassimilarwiththatrelatedtootherimmunosuppressants?ConclusionMZRisasafea
8、ndeffectiveimmunosuppressantwithmildadversereactions.CautiousmonitoringforhyperuricemiaandmyelosuppressionshouldberequiredwhenMZRisadministeredinrenaltransplantrecipients.Keywords：Mizoribine；Immunosuppressant；Renaltransplantation
