中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8297-8302.doi: 10.3969/j.issn.1673-8225.2010.44.032

• 器官移植学术探讨 academic discussion of organ transplantation • 上一篇    下一篇

钙调神经蛋白抑制剂引起的肾毒性：肾移植术后的早期预防和治疗

保泽庆，石  磊，赵树进   

  1. 解放军广州军区广州总医院药学部，广东省广州市   510010　
  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 通讯作者: 赵树进，教授，博士生导师，主任医师，解放军广州军区广州总医院药学部，广东省广州市 510010 gzzsjzhs@163.com
  • 作者简介:保泽庆★，男，1980年生，中山大学中山医学院在读硕士，主要从事临床药理学方面的研究。 zmj012@sohu.com
  • 基金资助:

    广东省科技计划项目社会发展计划(2005B30701004)。

Calcineurin inhibitors-induced nephrotoxicity: Early prevention and treatment following renal transplantation

Bao Ze-qing, Shi Lei, Zhao Shu-jin   

  1. Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA, Guangzhou  510010, Guangdong Province, China　
  • Online:2010-10-29 Published:2010-10-29
  • Contact: Zhao Shu-jin, Professor, Doctoral supervisor, Chief physician, Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA, Guangzhou 510010, Guangdong Province, China gzzsjzhs@163.com
  • About author:Bao Ze-qing★, Studying for master’s degree, Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA, Guangzhou 510010, Guangdong Province, China zmj012@sohu.com
  • Supported by:

    the Plan for Social Development of Science and Technology Plan Project of Guangdong Province, No.2005B30701004*

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摘要：

目的：就近年来国内外预防和治疗钙调神经蛋白抑制剂肾毒性的方法进行综述。
方法：应用PubMed检索及CNKI中国期刊全文数据库检索系统，以“环孢素A，他克莫司，钙调神经蛋白抑制剂肾毒性”和“Ciclosporine A，Tacrolimus，CNIS drug-induced chronic nephrotoxicity”为关键词检索相关文献。时间范围为1980-01/2010-01。选择文章主要内容与钙调神经蛋白抑制剂肾毒性直接相关、针对性强、代表性好、相关领域权威杂志的文章共44篇进行综述。
结果：环孢素A与他克莫司做为常用的免疫抑制剂，明显改善了器官移植者的生活质量和生存率，如果要取得移植肾的长期存活，必须考虑到导致移植物丧失功能的病因学问题。目前，已经证明慢性移植物肾病和钙调神经蛋白抑制剂的肾毒性是导致移植肾丧失功能的主要原因，而同时钙调神经蛋白抑制剂肾毒性在慢性移植物肾病的自然病程中又起到了重要的作用。
结论：目前没有有效预防和治疗钙调神经蛋白抑制剂肾毒性的手段。移植术后早期减少钙调神经蛋白抑制剂用量或撤除，或许是预防钙调神经蛋白抑制剂肾毒性更好的选择。

关键词: 环孢素A, 他克莫司, 钙调神经蛋白抑制剂, 肾毒性, 器官移植　

Abstract:

OBJECTIVE: To review the prevention and treatment for calcineurin inhibitors-induced nephrotoxicity.
METHODS: Using key words of “Ciclosporine A, Tacrolimus, CNIS drug-induced chronic nephrotoxicity”, documents published between January 1980 and January 2010 in databases of PubMed and CNKI were searched. Totally 44 articles closely related to calcineurin inhibitors-induced nephrotoxicity were reviewed.
RESULTS: Ciclosporin and tacrolimus were often employed as immunosuppressants, which notably improve life quality and survival rates of transplant recipients. However, long-term use of calcineurin inhibitors caused a characteristic type of chronic nephrotoxicity after renal transplantation and resulting in a decline of renal function. Currently, it has been confirmed that chronic allograft nephropathy and calcineurin inhibitors-induced nephrotoxicity are the main reasons for graft failure. The calcineurin inhibitors-induced nephrotoxicity plays an important role in natural course of chronic allograft nephropathy.
CONCLUSION: There is not an effective method for preventing or treating calcineurin inhibitors-induced nephrotoxicity. Thus, it may be a good choice for preventing calcineurin inhibitors-induced nephrotoxicity by reducing dose or withdraw of calcineurin inhibitors.

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