中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (31): 5769-5772.doi: 10.3969/j.issn.1673-8225.2011.31.016

• 肾移植 kidney transplantation • 上一篇    下一篇

他克莫司和环孢素A对肾移植后患者炎性细胞因子和血脂的影响

刘克普，易晓敏，马帅军，李智斌，张  更，袁建林   

  1. 解放军第四军医大学西京医院泌尿外科，陕西省西安市  710032
  • 收稿日期:2011-03-06 修回日期:2010-05-10 出版日期:2011-07-30 发布日期:2011-07-30
  • 作者简介:刘克普★，男，1983年生，甘肃省山丹县人，汉族，解放军第四军医大学在读硕士，医师，主要从事肾移植的免疫耐受研究。 liukepu@126. com

Effects of tacrolimus and cyclosporine A on inflammatory cytokines and blood lipid after renal transplantation

Liu Ke-pu, Yi Xiao-min, Ma Shuai-jun, Li Zhi-bin, Zhang Geng, Yuan Jian-lin   

  1. Department of Urology, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an   710032, Shaanxi Province, China
  • Received:2011-03-06 Revised:2010-05-10 Online:2011-07-30 Published:2011-07-30
  • About author:Liu Ke-pu★, Studying for master’s degree, Physician, Department of Urology, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an 710032, Shaanxi Province, China liukepu@126.com

PDF

301

被引次数

6

摘要：

背景：环孢素A与他克莫司是肾移植后临床广泛应用的免疫抑制剂。
目的：观察他克莫司和环孢素A对肾移植后炎性细胞因子和血脂的影响。
方法：选择首次接受同种异体肾移植后患者112例，随机分为环孢素A组和他克莫司组，移植后分别给予环孢素A+吗替麦考酚酯+糖皮质激素三联疗法与他克莫司+吗替麦考酚酯+糖皮质激素三联疗法。
结果与结论：他克莫司组的1年人/肾存活率、治疗逆转率高于环孢素A组(P < 0.05)，急性排斥反应发生率低于环孢素A组(P < 0.05)；移植后1个月及1年的血清白细胞介素2，6，8和血糖水平高于移植前(P < 0.05)，低于环孢素A组(P < 0.05)，血清白细胞介素4，10低于移植前(P < 0.05)，高于环孢素A组(P< 0.05)；移植后1个月的血清总胆固醇、三酰甘油和低密度脂蛋白胆固醇高于移植前(P < 0.05)，但低于环孢素A组(P < 0.05)；移植后1年的血清总胆固醇和低密度脂蛋白胆固醇低于环孢素A组(P < 0.05)。说明他克莫司可通过抑制肾移植后炎性细胞因子释放，改善糖脂代谢等途径降低患者的排斥反应，提高肾移植的存活率。

关键词: 他克莫司, 环孢素A, 肾移植, 细胞因子, 血脂

Abstract:

BACKGROUND: Tacrolimus (FK506) and cyclosporine A (CsA) are widely used immunosuppressive agents after renal transplantation in the clinic.
OBJECTIVE: To investigate the effects of FK506 and CsA on inflammatory cytokines and blood lipid after renal transplantation.
METHODS: Totally 112 patients who received renal allograft for the first time were randomly divided into two groups. The CsA group received a triple therapy of CsA, mycophenolate mofetil and glucocorticoid. The FK506 group received a triple therapy of FK506, mycophenolate mofetil and glucocorticoid. 1-year survival rate, reversing rate, serum concentrations of interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, fasting plasma glucose and blood lipid were measured in the FK50 and CsA groups.
RESULTS AND CONCLUSION: In the FK506 group, 1-year survival rate and reversing rate were significantly higher, while acute rejection rate was significantly lower, compared with the CsA group (P < 0.05). In the FK506 group, serum concentrations of IL-2, IL-6, IL-8 and fasting plasma glucose at 1 month and 1 year after transplantation were significantly higher compared with before transplantation (P < 0.05) and CsA group (P < 0.05). In the FK506 group, serum concentrations of IL-4 and IL-10 at 1 month and 1 year after transplantation were significantly lower compared with before transplantation (P < 0.05), but significantly higher compared with the CsA group (P < 0.05). In the FK506 group, total cholesterol, triacylglycerol and low density lipoprotein cholesterol at 1 month after transplantation were significantly higher compared with before transplantation (P < 0.05), but were significantly lower compared with the CsA group (P < 0.05). In the FK506 group, total cholesterol and low density lipoprotein cholesterol at 1 year after transplantation were significantly lower compared with CsA group (P < 0.05). These findings suggest that FK506 may reduce acute rejection and increase survival rate of renal transplantation via inhibiting the release of cytokines and improving glucose and lipid metabolisms.

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