丙型肝炎病毒RNA阳性的肾移植受者免疫抑制剂的应用

摘要

目的 探讨肾移植术后发生丙型肝炎的受者合理的免疫抑制方案.方法 将25例丙型肝炎病毒RNA(HCV RNA)阳性的患者分为3组,分别给予硫唑嘌呤(Aza)+环孢素A(CsA)+泼尼松(Pred)(Aza组)、霉酚酸酯(MMF)+CsA+Pred(MMF组)和MMF+Pred,并以30例HCV RNA阴性受者为对照.结果 Aza组有8/12的患者肝功能发生异常;MMF组有2/8的患者肝功能发生异常;MMF+Pred组原有的肝功能异常均好转;对照组有10例患者发生肝功能异常,经过调整Aza与CsA的剂量后,肝功能均在1周内全部好转.结论 HCV RNA阳性的患者肾移植术后宜采用MMF+CsA+Pred三联疗法;肝功能损害较难控制时,使用MMF+Pred可以稳定肝、肾功能.%Objective To study the use of immunosuppressives for the patients with virus C hepatitis(HCV)after renal transplantation.Methods Twenty-five cases of HCV-RNA(+)and 30 cases of HCV-RNA(-)as control group were analyzed.All patients were divided into the Aza group(n=12),MMF group(n=8)and MP(MMF+Pred)group(n=5).Results Eight casGS revealed abnormal liver function in the Aza group and 2 in MMF group.After stopping the use of CsA and Aza,the liver function all revealed good outcome in the MP group.During one week 30 cases of HCV-RNA(-)recovered due to the readjustment of the dosage of immunosupprexsives(CsA,Aza)in the control group.Conclnsions The therapy of MMF+CsA+Pred is necessary for the patients with HCV-RNA(+)and the function of the renal and liver can be stabilized by MMF.